Individual provider Active NPI

Ivanka Sophia Temnycky

  • Physician Assistant
  • New York, NY
National Provider Identifier
1376178574
Registry record updated Mar 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
024793 Issued in NY
Practice address
1468 Madison Ave
New York, NY 10029-6508
Phone
(212) 241-6500
NPI assigned
Mar 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 024793 NY Primary

Addresses

Primary practice location

1468 Madison Ave
New York, NY 10029-6508

Mailing address

246 E 46TH St Apt 4D
New York, NY 10017-2947
Phone (315) 558-8989

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
I20200527000537 NY Practitioner - Physician Assistant 5597186759 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
024793NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 8, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 8, 2024 Accepting new patients
Fpa Hospital Based CurrentSince May 19, 2020 Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

300 Cadman Plz W
Fl 18
Brooklyn, NY 11201
Phone (929) 210-6000

3201 Kings Hwy
Brooklyn, NY 11234
Phone (718) 252-3000

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1440 Madison Ave
New York, NY 10029
Phone (212) 241-5561

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

1468 Madison Ave
#3220
New York, NY 10029

234 E 85th St
New York, NY 10028
Phone (212) 241-6585

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

Networks

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

Organizations & group practices 7

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": "1583625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583625600000",
    "number": "1376178574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 E 46TH ST APT 4D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100172947",
            "telephone_number": "315-558-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMNYCKY",
        "first_name": "IVANKA",
        "middle_name": "SOPHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-08",
        "last_updated": "2020-03-08",
        "certification_date": "2020-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.