Individual provider Active NPI

Elena Dudorova, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1437766151
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
325266 Issued in NY
Practice address
1 Brookdale PLZ
Brooklyn, NY 11212-3139
Phone
(718) 240-6347
NPI assigned
Sep 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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 325266 NY Primary

Addresses

Primary practice location

1 Brookdale PLZ
Brooklyn, NY 11212-3139

Mailing address

1 Brookdale PLZ
Brooklyn, NY 11212-3139
Phone (718) 240-6347

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EDudorov@BHMCNY.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
I20230919002200 NY Practitioner - Internal Medicine 6002270402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

Hospital & facility affiliations

  • Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Brookdale Hospital Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Interfaith Professional Physician Services, P.C. Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
The Brookdale Hospital Medical Center Past Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

Networks

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

Organizations & group practices 4

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 4

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": "1601164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1437766151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDOROVA",
        "first_name": "ELENA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-27",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "325266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EDudorov@BHMCNY.ORG",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Brookdale Plz",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112123139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.