NPIMap

Individual provider Active NPI

Polina Tavrovskaya, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1437358934
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
245131 Issued in NY
Practice address
9000 Shore Rd
Brooklyn, NY 11209-5401
Phone
(718) 630-8890
Fax
(718) 491-1166
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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 245131 NY Primary

Addresses

Primary practice location

9000 Shore Rd
Brooklyn, NY 11209-5401

Mailing address

9000 Shore Rd
Brooklyn, NY 11209-5401
Phone (718) 630-8890

Other identifiers 1

IdentifierTypeStateIssuer
02900145MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ptavrovskaya132362@nyumc.direct-ci.com NYU Langone Hospitals

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070823000620 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 5698867521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NYU Langone HospitalsGroup PAC ID 4981515699, 245 clinicians

Practice addresses (Care Compare)

150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7942

301 E 17TH St
New York, NY 10003-3804
Phone (212) 598-2454

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals CurrentSince Jan 17, 2017 Accepting new patients
NYU Langone Hospitals Internal Medicine Current Accepting new patients
NYU Langone Hospitals CurrentSince Jan 17, 2017 Accepting new patients
NYU Lutheran Medical Center Past Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

150 55th St
Fl 1
Brooklyn, NY 11220
Phone (718) 630-8600

150 55th St
Rm 3618
Brooklyn, NY 11220
Phone (718) 630-7477

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

Networks

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

Interoperability endpoints

  • Direct secure messaging: ptavrovskaya132362@nyumc.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1437358934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 SHORE RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112095401",
            "telephone_number": "718-630-8890",
            "fax_number": "718-491-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 SHORE RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112095401",
            "telephone_number": "718-630-8890",
            "fax_number": "718-491-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVROVSKAYA",
        "first_name": "POLINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "245131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02900145",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptavrovskaya132362@nyumc.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "NYU Langone Hospitals",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.