Eliezer Gurkov, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

019398 Issued in NY

Practice address

175 Route 59
Spring Valley, NY 10977-5231

Phone

(845) 694-8888

Fax

(845) 501-2360

NPI assigned

Dec 31, 2015

Last updated

May 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

State University of New York Downstate Medical Center, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Care365 LLCGroup PAC ID 5496137325, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Care365 LLC

  • Primary Care Clinic/Center
  • Monsey, NY
  • NPI 1437774882
  Medicare reassignment Care Compare group
• Ahava Medical and Rehabilitation Center, LLC

  • Rehabilitation Practitioner
  • Brooklyn, NY
  • NPI 1184878274
  Medicare reassignment NPD
• Crown Heights Medical, P.C.

  • Multi-Specialty Clinic/Center
  • Monsey, NY
  • NPI 1821210402
  Medicare reassignment

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1447615737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 TAMARACK LN",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702005",
            "telephone_number": "718-864-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 ROUTE 59",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775231",
            "telephone_number": "845-694-8888",
            "fax_number": "845-501-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURKOV",
        "first_name": "ELIEZER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-31",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "019398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chaim Grunwald, LMHC
• Tamara Grynheim
• Charles Edward Guevara, BA DDS
• Joseph Mayer Gunsberg, BCBA, LBA
• Malka Dvora Gurbunov
• Shaina E. Gutman, OTR/L
• Karolyn Stephany Guzman, FNP
• Hadas Applied Behavior Analysis PLLC
• Tzipora Yetta Hadas, LBA, BCBA
• Kevin Michael Haggerty, DC

• Medical Physician Assistant in Spring Valley, NY
• Providers in Spring Valley, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.