Individual provider Active NPI

Dora Soybelman, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1497749535
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
218881 Issued in NY
Practice address
3099 Coney Island Ave
3 Floor
Brooklyn, NY 11235-6305
Phone
(718) 676-2277
Fax
(718) 676-2278
NPI assigned
Sep 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 218881 NY Primary

Addresses

Primary practice location

3099 Coney Island Ave
3 Floor
Brooklyn, NY 11235-6305

Mailing address

2434 83Rd St
Brooklyn, NY 11214-2706
Phone (718) 676-2277

Other identifiers 1

IdentifierTypeStateIssuer
02103560MedicaidNY

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
I20041206000500 NY Practitioner - Internal Medicine 2163488743 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

Hospital & facility affiliations

  • South Brooklyn Health Hospital, Brooklyn, NY, CCN 330196

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Apr 22, 2017 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients
Maimonides Medical Center - MMC Division of Geriatric Medicine FPP Past Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

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

Interoperability endpoints

  • Direct secure messaging: dsoybelman250792@nychhc.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1497749535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 83RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112142706",
            "telephone_number": "718-676-2277",
            "fax_number": "718-676-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3099 CONEY ISLAND AVE",
            "address_2": "3 FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356305",
            "telephone_number": "718-676-2277",
            "fax_number": "718-676-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOYBELMAN",
        "first_name": "DORA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-05",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "218881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02103560",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.