Individual provider Active NPI

Yuriy Pertsovsky

  • Gastroenterology Physician
  • Brooklyn, NY
National Provider Identifier
1326085168
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
214362 Issued in NY
Practice address
2569 Ocean Ave
Brooklyn, NY 11229-4576
Phone
(718) 743-7090
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 214362 NY Primary

Addresses

Primary practice location

2569 Ocean Ave
Brooklyn, NY 11229-4576

Mailing address

259 Dover St
Brooklyn, NY 11235-3721

Other identifiers 1

IdentifierTypeStateIssuer
02059612MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20041229000054 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 9335107960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifelong Medical, P.C.Group PAC ID 0547151532, 2 clinicians

Practice addresses (Care Compare)

2569 Ocean Ave
Brooklyn, NY 11229-4576
Phone (718) 645-7020

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
99.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy415
Upper gastrointestinal (GI) endoscopy for acid reflux211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214362NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical, P.C. Gastroenterology CurrentSince Aug 3, 2000 Accepting new patients
JRR Medical PC Gastroenterology PastSince Sep 1, 2019 Accepting new patients
New York Community Hospital of Brooklyn, Inc. Past Accepting new patients

Locations

1302 Kings Hwy
Fl 3
Brooklyn, NY 11229
Phone (718) 256-2222

259 Dover St
Brooklyn, NY 11235

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFFBDD/Endpoint/GFFBDD

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1326085168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 DOVER ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2569 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294576",
            "telephone_number": "718-743-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERTSOVSKY",
        "first_name": "YURIY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "214362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02059612",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.