Igny Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

210937 Issued in NY

Legal business name

IGNY MEDICAL PC

Practice address

3048 Brighton 1St St # 6B
Brooklyn, NY 11235-8080

Phone

(718) 945-4545

Fax

(347) 702-9545

NPI assigned

Oct 26, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Igor Zhuravenko, MD

Title

President

Phone

(347) 489-7777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604707200000",
    "number": "1437661741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 BEACH 137TH ST",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "11694",
            "telephone_number": "347-489-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 BRIGHTON 1ST ST # 6B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358080",
            "telephone_number": "718-945-4545",
            "fax_number": "347-702-9545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "197 Beach 137th St",
            "address_purpose": "LOCATION",
            "city": "Rockaway Park",
            "state": "NY",
            "postal_code": "11694",
            "country_code": "US",
            "telephone_number": "347-489-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IGNY MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2020-11-07",
        "certification_date": "2020-11-07",
        "status": "A",
        "authorized_official_last_name": "ZHURAVENKO",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-489-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "210937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.