Individual provider Active NPI

Liliya Drukman, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1437205168
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
212850 Issued in NY
Practice address
5923 16TH Ave
Brooklyn, NY 11204-2114
Phone
(718) 259-6122
Fax
(718) 259-6728
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 212850 NY Primary

Addresses

Primary practice location

5923 16TH Ave
Brooklyn, NY 11204-2114

Mailing address

5923 16TH Ave
Brooklyn, NY 11204-2114
Phone (718) 259-6122

Other identifiers 1

IdentifierTypeStateIssuer
01914507MedicaidNY

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address lid9034@direct.nyp.org Direct

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
I20190118002302 NY Practitioner - Pediatric Medicine 7618214206 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
212850NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC CurrentSince Nov 21, 2018 Accepting new patients
Kings Physician Services, PC CurrentSince Nov 21, 2018 Accepting new patients
Park Slope Physician Services PC Past Accepting new patients

Locations

1771 Utica Ave
Brooklyn, NY 11234
Phone (718) 209-0888

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

5923 16th Ave
Brooklyn, NY 11204
Phone (718) 259-6122

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1437205168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5923 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042114",
            "telephone_number": "718-259-6122",
            "fax_number": "718-259-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5923 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042114",
            "telephone_number": "718-259-6122",
            "fax_number": "718-259-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUKMAN",
        "first_name": "LILIYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "212850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01914507",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5923 16th Ave",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112042114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5923 16th Ave",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112042114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lid9034@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "direct messaging address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct messaging address",
            "address_1": "5923 16th Ave",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112042114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.