Individual provider Active NPI

Alla Bogorodovsky, MD

  • Adolescent Medicine (Internal Medicine) Physician
  • Yonkers, NY
National Provider Identifier
1558322800
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
238585 Issued in NY
Practice address
69 S Broadway
Yonkers, NY 10701-4004
Phone
(914) 376-5555
Fax
(914) 964-1477
NPI assigned
Mar 28, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 238585 NY Primary

Addresses

Primary practice location

69 S Broadway
Yonkers, NY 10701-4004

Mailing address

69 S Broadway
Yonkers, NY 10701-4004
Phone (914) 376-5555

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
I20060421000545 NY Practitioner - Internal Medicine 4688684533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
238585NYMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Sep 17, 2024 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Sep 1, 2010 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients
New York City Health and Hospitals Corporation 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 H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1558322800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107014004",
            "telephone_number": "914-376-5555",
            "fax_number": "914-964-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107014004",
            "telephone_number": "914-376-5555",
            "fax_number": "914-964-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGORODOVSKY",
        "first_name": "ALLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "NY",
            "license": "238585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.