Individual provider Active NPI

Baruch Kassover, MD

  • Internal Medicine Physician
  • Atlantic Beach, NY
National Provider Identifier
1467554840
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
183113 Issued in NY
Practice address
2001 Ocean Blvd
Atlantic Beach, NY 11509
Phone
(516) 371-0765
Fax
(516) 371-2866
NPI assigned
Sep 5, 2006
Last updated
May 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2011

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 183113 NY Primary

Addresses

Primary practice location

2001 Ocean Blvd
Atlantic Beach, NY 11509

Mailing address

1204 B 9TH St
Far Rockaway, NY 11691
Phone (718) 868-0320

Other identifiers 6

IdentifierTypeStateIssuer
2500300OtherGHI
2C1296OtherHEALTHNET
01495523MedicaidNY
1003605OtherAETNA
P406990OtherOXFORD
00074OtherGHI MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20130606000122 NJ Practitioner - Internal Medicine 5991848814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of Ny Upstate Medical University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1771 Madison Ave
Lakewood, NJ 08701-1242
Phone (732) 364-2144

1771 Madison Ave
Lakewood, NJ 08701-1251

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Resource and Referral Center Inc Current Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Apr 3, 2013 Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Apr 3, 2013 Accepting new patients

Locations

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

Interoperability endpoints

  • Direct secure messaging: baruch.kassover@chemed.eclinicaldirectplus.com

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.

Hospital & facility affiliations 3

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1467554840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 B 9TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691",
            "telephone_number": "718-868-0320",
            "fax_number": "718-868-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 OCEAN BLVD",
            "city": "ATLANTIC BEACH",
            "state": "NY",
            "postal_code": "11509",
            "telephone_number": "516-371-0765",
            "fax_number": "516-371-2866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSOVER",
        "first_name": "BARUCH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "183113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2500300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2C1296",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01495523",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1003605",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P406990",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "00074",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic Beach, NY

Sources for this page

Verify at the official NPI Registry.