Individual provider Active NPI

Yuriy Aronovich Gubenko, M.D.

  • Anesthesiology Physician
  • Newark, NJ
National Provider Identifier
1295882231
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07061300 Issued in NJ
Practice address
150 Bergen St
Level E
Newark, NJ 07103-2496
Phone
(973) 972-5254
Fax
(973) 972-4172
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA07061300 NJ Primary

Addresses

Primary practice location

150 Bergen St
Level E
Newark, NJ 07103-2496

Mailing address

30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000

Other identifiers 1

IdentifierTypeStateIssuer
8470901MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ygubenko10459@direct.uhnj.org Direct University Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120206000220 NJ Practitioner - Anesthesiology 1052578986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician Associates of New Jersey IncGroup PAC ID 9830003417, 374 clinicians

Practice addresses (Care Compare)

30 Bergen St
Newark, NJ 07107-3000
Phone (973) 972-0037

Hospital & facility affiliations

  • The University Hospital Hospital, Newark, NJ, CCN 310119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07061300NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc CurrentSince Jan 6, 2003 Accepting new patients
University Physician Associates of New Jersey Inc Anesthesiology CurrentSince Jan 6, 2003 Accepting new patients

Locations

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

30 Bergen St
Bldg 12
Newark, NJ 07107
Phone (973) 972-0037

Organizations & group practices 2

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1295882231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "address_2": "LEVEL E",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-5254",
            "fax_number": "973-972-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBENKO",
        "first_name": "YURIY",
        "middle_name": "ARONOVICH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07061300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8470901",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ygubenko10459@direct.uhnj.org",
            "affiliation": "Y",
            "endpointDescription": "Epic",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.