Individual provider Active NPI

Ivanna Govdysh

  • Registered Nurse
  • New York, NY
National Provider Identifier
1487544078
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
743886 Issued in NY
Practice address
1412 Broadway Ste 2109
New York, NY 10018-9228
Phone
(718) 724-2810
NPI assigned
Jul 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 743886 NY Primary

Addresses

Primary practice location

1412 Broadway Ste 2109
New York, NY 10018-9228

Mailing address

1412 Broadway Ste 2109
New York, NY 10018-9228

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
743886NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1487544078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 BROADWAY STE 2109",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100189228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 BROADWAY STE 2109",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100189228",
            "telephone_number": "718-724-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOVDYSH",
        "first_name": "IVANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "743886",
            "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 Jul 7, 2025; 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.