Individual provider Active NPI

Petr Leonidovich Tsenovoy, MD

  • Cardiovascular Disease Physician
  • Norwood, NJ
National Provider Identifier
1558507178
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA09126700 Issued in NJ
Practice address
19 Mohawk Ave
Norwood, NJ 07648-2410
Phone
(201) 392-3588
NPI assigned
Jan 2, 2009
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA09126700 NJ Primary
Hospitalist Physician 208M00000X 25MA09126700 NJ

Addresses

Primary practice location

19 Mohawk Ave
Norwood, NJ 07648-2410

Mailing address

95 Grasslands Rd
New York Med College, Munger Pavilion, Room 253
Valhalla, NY 10595-1652
Phone (914) 493-8373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20120727000548 NJ Practitioner - Internal Medicine 8022274513 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

55 Mdwlands Pkwy
Secaucus, NJ 07094-2977
Phone (617) 818-7474

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Nov 28, 2018 Accepting new patients
Hudson Premier Medical PC Hospitalist CurrentSince Mar 19, 2020 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Nov 28, 2018 Accepting new patients
Tsenovoy Medical PC Cardiovascular Disease CurrentSince Aug 1, 2022 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

38 Meadowlands Pkwy
Ste 205
Secaucus, NJ 07094
Phone (201) 552-2357

55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744

55 Meadowlands Pkwy
Fl 3
Secaucus, NJ 07094
Phone (201) 392-3588

55 Meadowlands Pkwy
Ste 1
Secaucus, NJ 07094
Phone (201) 392-3190

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Organizations & group practices 5

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": "1230854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1558507178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 GRASSLANDS RD",
            "address_2": "NEW YORK MED COLLEGE, MUNGER PAVILION, ROOM 253",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951652",
            "telephone_number": "914-493-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MOHAWK AVE",
            "city": "NORWOOD",
            "state": "NJ",
            "postal_code": "076482410",
            "telephone_number": "201-392-3588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSENOVOY",
        "first_name": "PETR",
        "middle_name": "LEONIDOVICH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-02",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA09126700",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA09126700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, NJ

Sources for this page

Verify at the official NPI Registry.