Individual provider Active NPI

Igor Romanov, NP

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1457565269
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F306828 Issued in NY
Practice address
2148 Ocean Ave FL 5
Brooklyn, NY 11229-1484
Phone
(212) 398-1288
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F306828 NY Primary
Primary Care Nurse Practitioner 363LP2300X F306828 NY

Addresses

Primary practice location

2148 Ocean Ave FL 5
Brooklyn, NY 11229-1484

Mailing address

131 Hastings St
Brooklyn, NY 11235-3017

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140919000892 NY Practitioner - Nurse Practitioner 2365661584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
May accept Medicare assignment
Group practices
Vanguard DermatologyGroup PAC ID 2365475977, 10 clinicians

Practice addresses (Care Compare)

2148 Ocean Ave
FL 5
Brooklyn, NY 11229-1484
Phone (212) 398-1288

380 Henry St
Brooklyn, NY 11201-6048
Phone (718) 855-6789

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
84.56
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F306828NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Health Quest Physical Therapy, P.C. CurrentSince Dec 15, 2019 Accepting new patients
Maimonides Medical Center Orthopaedic FPP Past Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: igor.romanov@pd.eclinicaldirectplus.com
  • Direct secure messaging: igorromanov@mai.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1457565269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HASTINGS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 OCEAN AVE FL 5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291484",
            "telephone_number": "212-398-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANOV",
        "first_name": "IGOR",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306828",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F306828",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.