Individual provider Active NPI

Roksana Borukhova, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Forest Hills, NY
National Provider Identifier
1457749392
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
002511-1 Issued in NY
Practice address
11011 72ND Ave
1B
Forest Hills, NY 11375-4910
Phone
(718) 261-9000
NPI assigned
Dec 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 002511-1 NY Primary

Addresses

Primary practice location

11011 72ND Ave
1B
Forest Hills, NY 11375-4910

Mailing address

8002 21 Avenue
3H
Brooklyn, NY 11214
Phone (347) 409-8958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160212000600 NY Practitioner - Qualified Audiologist 8527362888 Reassigns benefits to 1 organization
I20220801003276 FL Practitioner - Qualified Audiologist 8527362888

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4902 Queens Blvd
Suite 3
Woodside, NY 11377-4445
Phone (718) 577-2235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002511NYMDMental Health Counselor
002511-1NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Hills Audiology PC Audiologist-Hearing Aid Fitter CurrentSince Nov 14, 2015 Accepting new patients

Locations

11011 72nd Ave
Ste 1B
Forest Hills, NY 11375
Phone (718) 261-9000

4902 Queens Blvd
Ste 3
Woodside, NY 11377
Phone (718) 577-2235

Networks

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

Organizations & group practices 1

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": "1419897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1457749392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8002 21 AVENUE",
            "address_2": "3H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11214",
            "telephone_number": "347-409-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 72ND AVE",
            "address_2": "1B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754910",
            "telephone_number": "718-261-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORUKHOVA",
        "first_name": "ROKSANA",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-30",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NY",
            "license": "002511-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.