Individual provider Active NPI

Boris Glukhovskiy, RPA-C

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1467666222
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
008865 Issued in NY
Practice address
10 Union SQ E
Phillips Ambulatory Care Center, Orthopedic Surgery
New York, NY 10003-3314
Phone
(212) 844-6806
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 008865 NY Primary

Addresses

Primary practice location

10 Union SQ E
Phillips Ambulatory Care Center, Orthopedic Surgery
New York, NY 10003-3314

Mailing address

407 Father Capodanno Blvd
Staten Island, NY 10305-4242
Phone (718) 720-2038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008865NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York Community Hospital of Brooklyn, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bglukhovskiy@hiemail.healtheconnections.org

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1467666222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 FATHER CAPODANNO BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054242",
            "telephone_number": "718-720-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 UNION SQ E",
            "address_2": "PHILLIPS AMBULATORY CARE CENTER, ORTHOPEDIC SURGERY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033314",
            "telephone_number": "212-844-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUKHOVSKIY",
        "first_name": "BORIS",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "008865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.