Active NPI
David Koyenov
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1336944792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 033277
- Practice address
- 445 Lenox Rd
Brooklyn, NY 11203-2017 - Phone
- (718) 270-1000
- NPI assigned
- Feb 18, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 033277 | NY | Primary |
Addresses
Primary practice location
445 Lenox Rd
Brooklyn, NY 11203-2017
Mailing address
7508 172ND St
Fresh Meadows, NY 11366-1423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033277 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York City Health and Hospitals Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1679587679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739836800000",
"number": "1336944792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7508 172ND ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113661423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 LENOX RD",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032017",
"telephone_number": "718-270-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOYENOV",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-02-18",
"last_updated": "2025-02-18",
"certification_date": "2025-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "033277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.