Konstantin Pertsovsky, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MB07552900 Issued in NJ

Practice address

510 Hamburg Tpke
Wayne Commons, Suite 101
Wayne, NJ 07470-2025

Phone

(973) 942-6005

Fax

(973) 942-6009

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Merit-based Incentive Payment System (MIPS)

Final score

82.88 of 100Reported as group

Quality

81.99

Promoting interoperability

95

Improvement activities

20

Cost

69.63

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• North Haledon Medical, PC

  • Specialist
  • Wayne, NJ
  • NPI 1477624088
  Medicare reassignment
• Modern Medical PC

  • Primary Care Clinic/Center
  • New York, NY
  • NPI 1417057951
  NPD
• Larisa Veksman D.O P.C

  • Specialist
  • Brooklyn, NY
  • NPI 1942465091
  NPD (past)
• Prime Fitness Physical Therapy PC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1346421104
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1306876602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 LAFAYETTE AVE",
            "address_2": "APT.A",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070102024",
            "telephone_number": "201-840-4081",
            "fax_number": "201-840-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HAMBURG TPKE",
            "address_2": "WAYNE COMMONS, SUITE 101",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702025",
            "telephone_number": "973-942-6005",
            "fax_number": "973-942-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERTSOVSKY",
        "first_name": "KONSTANTIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB07552900",
            "primary": true
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NY",
            "license": "214845",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "214845",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157376",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Performance Physical Therapy & Sports Conditioning LLC
• Performance PT LLC
• Perinatal Services of Northern New Jersey
• Marissa Perrotta, RDN
• David Perry, Jr., PA-C
• Dennis J Petrusovich, MSW LSW
• Rachel Pettersen
• Rachel Peyser
• Pforp Health LLC
• Philip Bai, M.D. LLC.

• Internal Medicine Physician in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.