Individual provider Active NPI

Boris Gershteyn, D.C.

  • Chiropractor
  • Forest Hills, NY
National Provider Identifier
1295938702
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011497 Issued in NY
Practice address
7020 Yellowstone Blvd
Forest Hills, NY 11375
Phone
(646) 660-4828
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X011497 NY Primary
Chiropractor 111N00000X 38MC00662900 NJ

Addresses

Primary practice location

7020 Yellowstone Blvd
Forest Hills, NY 11375

Mailing address

7020 Yellowstone Blvd
Forest Hills, NY 11375-3500
Phone (646) 660-4828

Other practice location 1

104-60 Queens Blvd. Suite CH
Forest Hills, NY 11375
Phone (646) 660-4828

Other identifiers 2

IdentifierTypeStateIssuer
X011497OtherNYSTATE OF NEW YORK
38MC00662900OtherNJSTATE OF NEW JERSEY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140905000344 NY Practitioner - Chiropractic 6800014887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7020 Yellowstone Blvd
Forest Hills, NY 11375-7318
Phone (646) 660-4828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00662900NJMDChiropractor
X011497NYMDChiropractor
011497NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bodyworx Chiropractic PLLC Chiropractor CurrentSince Nov 8, 2013 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1295938702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 YELLOWSTONE BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753500",
            "telephone_number": "646-660-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7020 YELLOWSTONE BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "646-660-4828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104-60 Queens Blvd. Suite CH",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "11375",
            "country_code": "US",
            "telephone_number": "646-660-4828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERSHTEYN",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011497",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00662900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEW YORK",
            "identifier": "X011497",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEW JERSEY",
            "identifier": "38MC00662900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.