Active NPI
Olga Steklova, MD
- Family Medicine Physician
- Bayside, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 228780
- Practice address
- 21111 Northern Blvd
Bayside, NY 11361-3241 - Phone
- (718) 705-1000
- Fax
- (718) 705-1000
- NPI assigned
- Jul 26, 2005
- Last updated
- Jan 20, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 228780 | NY | Primary |
Addresses
Primary practice location
21111 Northern Blvd
Bayside, NY 11361-3241
Mailing address
21111 Northern Blvd
Bayside, NY 11361-3241
Phone (718) 705-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02489825 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
21111 Northern Blvd
Bayside, NY 11361-3241
Phone (718) 705-1000
460 W 34TH St
FL 9
New York, NY 10001-2382
Phone (212) 273-6100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 228780 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Healthcare, Inc. | Current | Accepting new patients | |
| Premier Healthcare, Inc. | Current | Accepting new patients |
Locations
21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474
21111 Northern Blvd
#13292
Bayside, NY 11361
Phone (718) 705-1000
3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790
175 Remsen St
Brooklyn, NY 11201
Phone (718) 303-1300
21111 Northern Blvd
Fl 2
Flushing, NY 11361
Phone (718) 224-2094
460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- olga.steklova.p1@direct.premierhealthcare.nextgenshare.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Developmental Disabilities Clinic/Center
- New York, NY
- NPI 1760436190
-
- Developmental Disabilities Clinic/Center
- New York, NY
- NPI 1831330182
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba NYP-Queens Diagnostic Lab
- Clinical Medical Laboratory
- Flushing, NY
- NPI 1053429274
Hospital
-
dba Transitional Care Unit
- Skilled Nursing Facility
- Flushing, NY
- NPI 1689958779
Hospital
-
- General Acute Care Hospital
- Flushing, NY
- NPI 1952347205
-
- General Acute Care Hospital
- Manhasset, NY
- NPI 1366459570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327017600000",
"number": "1508866195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21111 NORTHERN BLVD",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613241",
"telephone_number": "718-705-1000",
"fax_number": "718-224-1767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21111 NORTHERN BLVD",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613241",
"telephone_number": "718-705-1000",
"fax_number": "718-705-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEKLOVA",
"first_name": "OLGA",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-26",
"last_updated": "2012-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "228780",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02489825",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.