Organization Active NPI

New York Comprehensive Neurology PC

  • Neurology Physician
  • Brooklyn, NY
National Provider Identifier
1487087201
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
258729 Issued in NY
Legal business name
NEW YORK COMPREHENSIVE NEUROLOGY PC
Practice address
55 Greene Ave
Brooklyn, NY 11238-6406
Phone
(646) 641-8292
NPI assigned
Aug 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Authorized official

Name
Dr. Dmitry Shmerkovich, DONPI 1043486285
Title
Owner
Phone
(646) 641-8292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 258729 NY Primary

Addresses

Primary practice location

55 Greene Ave
Brooklyn, NY 11238-6406

Mailing address

2711 Avenue X Apt 3E
Brooklyn, NY 11235-2028
Phone (646) 641-8292

Other identifiers 1

IdentifierTypeStateIssuer
258729OtherNYLISCENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131206000227 NY Part B Supplier - Clinic/Group Practice 4082841648 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1307 Gravesend Neck Rd
Brooklyn, NY 11229

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1487087201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 AVENUE X APT 3E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352028",
            "telephone_number": "646-641-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 GREENE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112386406",
            "telephone_number": "646-641-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK COMPREHENSIVE NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-15",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "SHMERKOVICH",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-641-8292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "258729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENCE",
            "identifier": "258729",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.