Individual provider Active NPI

Mikhail Ilych Akselrud, DO

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1407946833
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
206712 Issued in NY
Practice address
1501 80TH Street
1St Floor
Brooklyn, NY 11228
Phone
(718) 837-2660
Fax
(718) 837-3662
NPI assigned
Oct 14, 2006
Last updated
Mar 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 206712 NY Primary

Addresses

Primary practice location

1501 80TH Street
1St Floor
Brooklyn, NY 11228

Mailing address

1501 80TH Street
1St Floor
Brooklyn, NY 11228
Phone (718) 837-2660

Other identifiers 1

IdentifierTypeStateIssuer
01952038MedicaidNY

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
I20120411000026 NY Practitioner - Family Practice 9830350370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1523 Voorhies Ave
FL 4
Brooklyn, NY 11235-3912
Phone (718) 517-2500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Galaxy Medical PC Family Medicine CurrentSince Oct 31, 2017 Accepting new patients
Prospect Park Medical Plaza PC Family Medicine CurrentSince Nov 9, 2019 Accepting new patients

Locations

1523 Voorhies Ave
Fl 4
Brooklyn, NY 11235
Phone (718) 332-5089

68 E 131st St
Ste 100
New York, NY 10037
Phone (212) 281-8600

Networks

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

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, 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": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1407946833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 80TH STREET",
            "address_2": "1ST FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11228",
            "telephone_number": "718-837-2660",
            "fax_number": "718-837-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 80TH STREET",
            "address_2": "1ST FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11228",
            "telephone_number": "718-837-2660",
            "fax_number": "718-837-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKSELRUD",
        "first_name": "MIKHAIL",
        "middle_name": "ILYCH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "206712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01952038",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.