Individual provider Active NPI

Boris Nemirovsky, MD

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
National Provider Identifier
1316059462
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
032418E Issued in PA
Practice address
9892 Bustleton Ave
Ste 206
Philadelphia, PA 19115-2139
Phone
(215) 698-2220
Fax
(215) 464-1808
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 032418E PA Primary

Addresses

Primary practice location

9892 Bustleton Ave
Ste 206
Philadelphia, PA 19115-2139

Mailing address

PO Box 52036
Philadelphia, PA 19115-7036
Phone (215) 698-2220

Other identifiers 18

IdentifierTypeStateIssuer
232610603OtherCIGNA
5444501OtherAETNA PPO GROUP PIN
0010005980001MedicaidPA
0100059801OtherAMERICHOICE
098916T50OtherMEDICARE PIN
090307OtherMEDICARE GROUP
98916OtherHIGHMARCK BCBS PIN
P2784771OtherOXFORD HEALTH PLAN
0058439000OtherKHPE KH65 AMERIHEALTH HMO
0876682OtherAETNA HMO GROUP PIN
98916OtherHORIZON
P11221508OtherMULTIPLAN HEALTH EOS
1013277410001OtherDPA GROUP
1702545OtherHIGHMARK BCBS GROUP
249697OtherHEALTHNET
0010005980001OtherDPA
1048941OtherKEYSTONE MERCY
2374620000OtherKHPE KH65 AMERIHEALTH HMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050711000108 PA Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 8921066523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9892 Bustleton Ave
Suite 206
Philadelphia, PA 19115-2139
Phone (215) 698-2220

Hospital & facility affiliations

  • Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032418EPAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
L&M Medical Associates, P.C. PastSince Jul 25, 2005 Accepting new patients

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1316059462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52036",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191157036",
            "telephone_number": "215-698-2220",
            "fax_number": "215-464-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9892 BUSTLETON AVE",
            "address_2": "STE 206",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152139",
            "telephone_number": "215-698-2220",
            "fax_number": "215-464-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMIROVSKY",
        "first_name": "BORIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "032418E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "232610603",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO GROUP PIN",
            "identifier": "5444501",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010005980001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0100059801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "098916T50",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "090307",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARCK BCBS PIN",
            "identifier": "98916",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "P2784771",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHPE KH65 AMERIHEALTH HMO",
            "identifier": "0058439000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO GROUP PIN",
            "identifier": "0876682",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "98916",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN HEALTH EOS",
            "identifier": "P11221508",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPA GROUP",
            "identifier": "1013277410001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS GROUP",
            "identifier": "1702545",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "249697",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPA",
            "identifier": "0010005980001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1048941",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHPE KH65 AMERIHEALTH HMO",
            "identifier": "2374620000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.