NPIMap

Organization Active NPI

Modern Medical Care PC

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1417258161
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
090829 Issued in NY
Legal business name
MODERN MEDICAL CARE PC
Practice address
312 Neptune Ave
Brooklyn, NY 11235-6875
Phone
(718) 934-7593
Fax
(718) 891-2636
NPI assigned
Nov 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Authorized official

Name
Aleksandr Orlovskiy, MDNPI 1457501447
Title
Owner
Phone
(718) 934-7593

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 090829 NY Primary

Addresses

Primary practice location

312 Neptune Ave
Brooklyn, NY 11235-6875

Mailing address

9602 4TH Ave
Apt 6N
Brooklyn, NY 11209-7851
Phone (718) 934-7593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110302000189 NY Part B Supplier - Clinic/Group Practice 8224219860 Receives reassigned benefits from 12 practitioners
Practice locations: Arverne, NY; Brooklyn, NY; Staten Island, NY

National Provider Directory

National Provider Directory

Locations

3816 Nostrand Ave
Brooklyn, NY 11235
Phone (347) 713-6871

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1417258161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9602 4TH AVE",
            "address_2": "APT 6N",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097851",
            "telephone_number": "718-934-7593",
            "fax_number": "718-891-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 NEPTUNE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356875",
            "telephone_number": "718-934-7593",
            "fax_number": "718-891-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "ORLOVSKIY",
        "authorized_official_first_name": "ALEKSANDR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-934-7593",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "090829",
            "primary": true
        }
    ],
    "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 Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.