Individual provider Active NPI

Polina Gulkarov

  • Adult Health Nurse Practitioner
  • Fresh Meadows, NY
National Provider Identifier
1326762840
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
310432 Issued in NY
Practice address
7304 184TH St
Fresh Meadows, NY 11366-1713
Phone
(917) 535-5998
NPI assigned
Sep 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 310432 NY Primary

Addresses

Primary practice location

7304 184TH St
Fresh Meadows, NY 11366-1713

Mailing address

7304 184TH St
Fresh Meadows, NY 11366-1713
Phone (917) 535-5998

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230724001103 NY Practitioner - Nurse Practitioner 1355701269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tatiana Khrom MD PCGroup PAC ID 1557368859, 10 clinicians

Practice addresses (Care Compare)

2797 Ocean Pkwy
Suite 3
Brooklyn, NY 11235-7868
Phone (718) 615-4000

8421 Bay Pkwy
Brooklyn, NY 11214-3303
Phone (718) 615-4000

Merit-based Incentive Payment System (MIPS)

Final score
87.02 of 100Reported as group
Quality
78.14
Promoting interoperability
59
Improvement activities
40
Cost
79.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Hills Dermatology Group PLLC CurrentSince Jun 10, 2023 Accepting new patients
Tatiana Khrom, M.D., P.C. CurrentSince Jul 1, 2024 Accepting new patients
Atlantic Gastroenterology, P.C. PastSince Aug 25, 2024 Accepting new patients

Locations

2797 Ocean Pkwy
Ste 3
Brooklyn, NY 11235
Phone (718) 615-4000

8421 Bay Pkwy
Brooklyn, NY 11214
Phone (718) 615-4000

14717 Jamaica Ave
Jamaica, NY 11435
Phone (718) 658-1700

8002 Kew Gardens Rd
Ste 107
Kew Gardens, NY 11415
Phone (718) 459-0900

10002 Rockaway Blvd
Ste 2
Ozone Park, NY 11417
Phone (718) 380-2330

Interoperability endpoints

  • Direct secure messaging: pgulkarov@directaddress.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1326762840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7304 184TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661713",
            "telephone_number": "917-535-5998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7304 184TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661713",
            "telephone_number": "917-535-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULKAROV",
        "first_name": "POLINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.