Individual provider Active NPI

Lyudmila Mogilevskaya

  • Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1487174546
Registry record updated Jun 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F305531-1 Issued in NY
Practice address
1877 E 12TH St Apt 5a
Brooklyn, NY 11229-2718
Phone
(347) 850-5400
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F305531-1 NY Primary

Addresses

Primary practice location

1877 E 12TH St Apt 5a
Brooklyn, NY 11229-2718

Mailing address

1877 E 12TH St Apt 5a
Brooklyn, NY 11229-2718
Phone (347) 850-5400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181031001758 NY Practitioner - Nurse Practitioner 9739432253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
71.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
305531NYMDPediatrics Physician
F305531-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shore Medical PC CurrentSince Sep 9, 2018 Accepting new patients

Locations

2865 Brighton 3rd St
Brooklyn, NY 11235
Phone (718) 645-1118

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": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497916800000",
    "number": "1487174546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1877 E 12TH ST APT 5A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292718",
            "telephone_number": "347-850-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1877 E 12TH ST APT 5A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292718",
            "telephone_number": "347-850-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGILEVSKAYA",
        "first_name": "LYUDMILA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2017-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F305531-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.