NPIMap

Individual provider Active NPI

Mikhail Bershadsky, PHARM D.

  • Pharmacist
  • New York, NY
National Provider Identifier
1386967214
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20 054381 Issued in NY
Practice address
126 8TH Ave
New York, NY 10011-5108
Phone
(212) 807-8798
Fax
(212) 645-1429
NPI assigned
Mar 6, 2010
Last updated
Nov 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 054381 NY
Pharmacist 183500000X 20 054381 NY Primary

Addresses

Primary practice location

126 8TH Ave
New York, NY 10011-5108

Mailing address

2940 Ocean Pkwy
Apt 19K
Brooklyn, NY 11235-8200

Other practice location 1

145 4th Ave
New York, NY 10003-4906
Phone (212) 677-0214

Other practice location 2

2575 Broadway
New York, NY 10025-5657
Phone (212) 678-8556

Other names 1

  • Michael Bershadsky Other name

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
054381NYMDPharmacist
20 054381NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Pharmacy LLC CurrentSince Feb 7, 2021 Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients
Procare Pharmacy, LLC. PastSince Dec 6, 2020 Accepting new patients
Walgreen Co Past Accepting new patients

Locations

126 8th Ave
New York, NY 10011
Phone (212) 352-5201

Organizations & group practices 5

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": "1267833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1386967214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 OCEAN PKWY",
            "address_2": "APT 19K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 8TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115108",
            "telephone_number": "212-807-8798",
            "fax_number": "212-645-1429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 4th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100034906",
            "country_code": "US",
            "telephone_number": "212-677-0214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2575 Broadway",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100255657",
            "country_code": "US",
            "telephone_number": "212-678-8556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERSHADSKY",
        "first_name": "MIKHAIL",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-06",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "054381",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "20 054381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "BERSHADSKY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.