Individual provider Active NPI

Lyubov Avshalumova, D.O.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1407157928
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
256828-1 Issued in NY
Practice address
80 Beekman Street
New York, NY 10038-9991
Phone
(212) 674-7777
Fax
(212) 729-9395
NPI assigned
Nov 15, 2010
Last updated
Apr 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 256828-1 NY Primary

Addresses

Primary practice location

80 Beekman Street
New York, NY 10038-9991

Mailing address

80 Beekman Street
New York, NY 10038-9991
Phone (212) 674-7777

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
I20110216001025 NY Practitioner - Dermatology 1759562291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Medical PCGroup PAC ID 2769458090, 7 clinicians

Practice addresses (Care Compare)

225 Broadway
Suite 910
New York, NY 10007-3008
Phone (212) 571-5000

80 Beekman St
New York, NY 10038-1891
Phone (212) 729-7546

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions140
Skin biopsy43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256828-1NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southbridge Pharmacy Inc CurrentSince Jun 30, 2024 Accepting new patients
Modern Medical PC CurrentSince Jul 14, 2025 Accepting new patients

Locations

225 Broadway
Ste 910
New York, NY 10007
Phone (212) 571-5000

Networks

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

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1407157928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 BEEKMAN STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100389991",
            "telephone_number": "212-674-7777",
            "fax_number": "212-729-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BEEKMAN STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100389991",
            "telephone_number": "212-674-7777",
            "fax_number": "212-729-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVSHALUMOVA",
        "first_name": "LYUBOV",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "256828-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.