Individual provider Active NPI

Eugene Dinkevich, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1487648101
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
199221-1 Issued in NY
Practice address
445 Lenox Rd
Brooklyn, NY 11203-2017
Phone
(718) 270-4714
NPI assigned
Sep 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 199221-1 NY Primary

Addresses

Primary practice location

445 Lenox Rd
Brooklyn, NY 11203-2017

Mailing address

445 Lenox Rd
Box 1262
Brooklyn, NY 11203-2017
Phone (718) 270-4714

Other identifiers 1

IdentifierTypeStateIssuer
01669194MedicaidNY

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
199221-1NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1487648101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 LENOX RD",
            "address_2": "BOX 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032017",
            "telephone_number": "718-270-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 LENOX RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032017",
            "telephone_number": "718-270-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINKEVICH",
        "first_name": "EUGENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "199221-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01669194",
            "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 Aug 28, 2012; 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.