Individual provider Active NPI

Aleksandra Zagorin, NP

  • Gerontology Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1316909195
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
F340559-1 Issued in NY
Practice address
4802 10TH Ave
Maimonides Medical Center Geriatric Division
Brooklyn, NY 11219-2916
Phone
(718) 283-7071
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X F340559-1 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Maimonides Medical Center Geriatric Division
Brooklyn, NY 11219-2916

Mailing address

4802 10TH Ave
Maimonides Medical Center Geriatrics Division
Brooklyn, NY 11219-2844
Phone (718) 283-7071

Other identifiers 2

IdentifierTypeStateIssuer
P3165982OtherNYOXFORD PROVIDER ID
02421992MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040417000128 NY Practitioner - Nurse Practitioner 9931194156 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F340559-1NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Boro Park Operating Co LLC CurrentSince Dec 5, 2011 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Jan 15, 2015 Accepting new patients

Locations

4915 10th Ave
Brooklyn, NY 11219
Phone (718) 851-3700

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Networks

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

Interoperability endpoints

  • Direct secure messaging: aleksandra.zagorin.p1@direct.mmc.nextgenshare.com
  • Direct secure messaging: aleksandrazagorin@mai.allscriptsdirect.net

Organizations & group practices 3

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316909195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "address_2": "MAIMONIDES MEDICAL CENTER GERIATRICS DIVISION",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192844",
            "telephone_number": "718-283-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "address_2": "MAIMONIDES MEDICAL CENTER GERIATRIC DIVISION",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAGORIN",
        "first_name": "ALEKSANDRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F340559-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER ID",
            "identifier": "P3165982",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02421992",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.