Individual provider Active NPI

Dmitry Zhukovski, D.O.

  • Family Medicine Physician
  • Hallandale Beach, FL
National Provider Identifier
1295728731
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS18656 Issued in FL
Practice address
2500 E Hallandale Beach Blvd Ste 505
Hallandale Beach, FL 33009-4838
Phone
(786) 733-1066
Fax
(786) 839-3258
NPI assigned
Aug 30, 2005
Reactivated
Apr 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS18656 FL Primary
Family Medicine Physician 207Q00000X 232986 NY

Addresses

Primary practice location

2500 E Hallandale Beach Blvd Ste 505
Hallandale Beach, FL 33009-4838

Mailing address

4766B Bedford Ave
Brooklyn, NY 11235-2606
Phone (718) 676-0404

Other practice location 1

4766B Bedford Ave
Brooklyn, NY 11235-2606
Phone (718) 676-0404

Other identifiers 2

IdentifierTypeStateIssuer
02385046MedicaidNY
113967000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040710000161 NY Practitioner - Family Practice 6608854245 Reassigns benefits to 1 organization
I20221101003007 FL Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 6608854245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bright Care Family Medicine CorpGroup PAC ID 9436526696, 3 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Practice addresses (Care Compare)

2500 E Hallandale Beach Blvd
Suite 505
Hallandale Beach, FL 33009-4838
Phone (917) 256-9127

4766 -B Bedford Ave
Brooklyn, NY 11235-2606
Phone (917) 617-3830

7015 Beracasa Way
Boca Raton, FL 33433-3453
Phone (561) 939-2033

Hospital & facility affiliations

  • Professional Home Health Services LLC Home health agency, North Miami Beach, FL, CCN 687048
  • Professional Home Health Services LLC Home health agency, Hallandale Beach, FL, CCN 687093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
232986NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Care Family Medicine Corp Single Specialty CurrentSince Sep 1, 2022 Accepting new patients
Broward Medical Consultants LLC Single Specialty CurrentSince Feb 6, 2025 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients
Executive Medical Care,P.C. Single Specialty PastSince Dec 1, 2012 Accepting new patients
Brooklyn Family Medical Care Single Specialty Past Accepting new patients
Akh Medical PC Single Specialty Past Accepting new patients
Prominis Medical Services PC Single Specialty Past Accepting new patients
Jal 28 LLC Single Specialty Past Accepting new patients
Oleg Karpenko Podiatry P.C. Single Specialty Past Accepting new patients

Locations

2500 E Hallandale Beach Blvd
Ste 505
Hallandale Beach, FL 33009
Phone (305) 909-6325

1920 E Hallandale Beach Blvd
Ste 901
Hallandale Beach, FL 33009
Phone (954) 204-0054

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1295728731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4766B BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352606",
            "telephone_number": "718-676-0404",
            "fax_number": "347-462-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E HALLANDALE BEACH BLVD STE 505",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094838",
            "telephone_number": "786-733-1066",
            "fax_number": "786-839-3258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4766B Bedford Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112352606",
            "country_code": "US",
            "telephone_number": "718-676-0404",
            "fax_number": "347-462-1280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHUKOVSKI",
        "first_name": "DMITRY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS18656",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "232986",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02385046",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113967000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

Verify at the official NPI Registry.