Individual provider Active NPI

Dmitriy Tonkonogiy, RPA-C

  • Surgical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1376690511
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
010775-1 Issued in NY
Practice address
445 Lenox Rd
Brooklyn, NY 11203-2017
Phone
(718) 270-2111
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 010775-1 NY Primary
Physician Assistant 363A00000X 010775-1 NY

Addresses

Primary practice location

445 Lenox Rd
Brooklyn, NY 11203-2017

Mailing address

PO Box 350707
Brooklyn, NY 11235-0707
Phone (718) 753-7302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
010775-1NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1376690511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350707",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112350707",
            "telephone_number": "718-753-7302"
        },
        {
            "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": "718-270-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONKONOGIY",
        "first_name": "DMITRIY",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "010775-1",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010775-1",
            "primary": false
        }
    ],
    "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 Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.