Individual provider Active NPI

Elena A Rogova, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1396745931
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
209860 Issued in NY
Practice address
2600 Netherland Ave
Ste. 110
Bronx, NY 10463-4801
Phone
(718) 432-8181
Fax
(718) 432-9191
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 209860 NY Primary

Addresses

Primary practice location

2600 Netherland Ave
Ste. 110
Bronx, NY 10463-4801

Mailing address

2600 Netherland Ave
Ste. 110
Bronx, NY 10463-4801
Phone (718) 432-8181

Other identifiers 1

IdentifierTypeStateIssuer
01828808MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040107000084 NY Practitioner - Internal Medicine 7113826348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Physical Medicine and Rehabilitation Center PA PastSince Jan 1, 2005 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: elr9082@direct.nyp.org

Organizations & group practices 2

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1396745931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 NETHERLAND AVE",
            "address_2": "STE. 110",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104634801",
            "telephone_number": "718-432-8181",
            "fax_number": "718-432-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NETHERLAND AVE",
            "address_2": "STE. 110",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104634801",
            "telephone_number": "718-432-8181",
            "fax_number": "718-432-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGOVA",
        "first_name": "ELENA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "209860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01828808",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.