Individual provider Active NPI

Vladimir Alexeyenko, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1447365382
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
211233 Issued in NY
Practice address
31 Washington SQ W
5F
New York, NY 10011-9126
Phone
(212) 675-7780
Fax
(212) 675-9801
NPI assigned
Aug 20, 2006
Last updated
Dec 11, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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 211233 NY Primary

Addresses

Primary practice location

31 Washington SQ W
5F
New York, NY 10011-9126

Mailing address

31 Washington Square West
Suite 5F
New York, NY 10014
Phone (212) 675-7780

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
I20050528000023 NY Practitioner - Internal Medicine 8022058031 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Diagnostics and Interventional Radiology, P.C. CurrentSince Dec 1, 2020 Accepting new patients
Bay Physmed, P.C. Past Accepting new patients

Locations

2560 Ocean Ave
Brooklyn, NY 11229
Phone (718) 615-4100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1447365382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 WASHINGTON SQUARE WEST",
            "address_2": "SUITE 5F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10014",
            "telephone_number": "212-675-7780",
            "fax_number": "212-675-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 WASHINGTON SQ W",
            "address_2": "5F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100119126",
            "telephone_number": "212-675-7780",
            "fax_number": "212-675-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXEYENKO",
        "first_name": "VLADIMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "211233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.