Andrey Goncharuk, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

199896 Issued in NY

Practice address

300 Old Country Rd
Suite 111
Mineola, NY 11501-4198

Phone

(516) 745-0500

Fax

(516) 745-1534

NPI assigned

Jul 8, 2005

Last updated

Aug 9, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Queens Nassau Nephrology Services PLLC

  • Nephrology Physician
  • Mineola, NY
  • NPI 1992934467
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1356349922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD",
            "address_2": "SUITE 111",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014198",
            "telephone_number": "516-745-0500",
            "fax_number": "516-745-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OLD COUNTRY RD",
            "address_2": "SUITE 111",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014198",
            "telephone_number": "516-745-0500",
            "fax_number": "516-745-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCHARUK",
        "first_name": "ANDREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "199896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01888637",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helga Golemi, PA-C
• Maria Gomez, MD
• Irving H Gomolin, M.D.,
• Joao Pedro Goncalves Kasakewitch, MD
• John J Goncalves, MD
• Irfan Gondal
• Aliana Gonzalez
• Erin K Gonzalez, MD
• Kimsue Gonzalez
• Lorena D Gonzalez, LAC

• Nephrology Physician in Mineola, NY
• Providers in Mineola, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.

Verify at the official NPI Registry.