Individual provider Active NPI

Igor Chernyavskiy, M.D.

  • Pulmonary Disease Physician
  • Brooklyn, NY
National Provider Identifier
1477520245
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
214470 Issued in NY
Practice address
2625 E 14TH St
Suite 201
Brooklyn, NY 11235-3973
Phone
(718) 891-7800
Fax
(718) 332-7246
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 214470 NY
Pulmonary Disease Physician 207RP1001X 214470 NY Primary

Addresses

Primary practice location

2625 E 14TH St
Suite 201
Brooklyn, NY 11235-3973

Mailing address

16 Tallow LN
Lake Grove, NY 11755-1806
Phone (631) 261-4400

Other identifiers 1

IdentifierTypeStateIssuer
02318261MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040722000655 NY Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 5092795898 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2625 E 14TH St
Suite 201
Brooklyn, NY 11235-3973
Phone (718) 891-7800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214470NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mihail Medvedovsky Physician PC CurrentSince Mar 21, 2011 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Mar 31, 1988 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Pulmonary Disease CurrentSince Mar 31, 1988 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Pulmonary and Sleep Disorders of New York, P.C. CurrentSince Nov 14, 2003 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

Locations

2625 E 14th St
Ste 201
Brooklyn, NY 11235
Phone (718) 275-1485

3039 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 946-9070

16806 Hillside Ave
Jamaica, NY 11432
Phone (516) 499-1846

100 Nicolls Rd
#13202
Stony Brook, NY 11794

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Interoperability endpoints

  • Direct secure messaging: igor.chernyavskiy@direct.stonybrookmedicine.edu

Organizations & group practices 6

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1477520245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 TALLOW LN",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551806",
            "telephone_number": "631-261-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 E 14TH ST",
            "address_2": "SUITE 201",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353973",
            "telephone_number": "718-891-7800",
            "fax_number": "718-332-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNYAVSKIY",
        "first_name": "IGOR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "214470",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "214470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02318261",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.