Individual provider Active NPI

Alexander Goncharov, MD

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1497905293
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
250481 Issued in NY
Practice address
233 Nostrand Ave
Brooklyn, NY 11205-4924
Phone
(718) 826-5900
Fax
(718) 826-5860
NPI assigned
Sep 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 250481 NY Primary

Addresses

Primary practice location

233 Nostrand Ave
Brooklyn, NY 11205-4924

Mailing address

800 Axinn Ave
Garden City, NY 11530-2139
Phone (646) 680-2888

Other identifiers 1

IdentifierTypeStateIssuer
03100290MedicaidNY

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
I20081203000730 NY Practitioner - Obstetrics/Gynecology 6305907791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goncharov Medical PCGroup PAC ID 2062739246, 21 clinicians

Practice addresses (Care Compare)

274 Madison Ave
RM 300
New York, NY 10016-0701
Phone (212) 201-1217

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Long Island Medical Group, P.C. Obstetrics & Gynecology Past Accepting new patients
Yelena Rubinshteyn MD PC Past Accepting new patients

Organizations & group practices 3

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1497905293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 AXINN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302139",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112054924",
            "telephone_number": "718-826-5900",
            "fax_number": "718-826-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCHAROV",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "250481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03100290",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.