Individual provider Active NPI

Svetlana Pertsovsky, MD

  • Gastroenterology Physician
  • Brooklyn, NY
National Provider Identifier
1578607230
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
218207 Issued in NY
Practice address
1302 Kings Hwy
Brooklyn, NY 11229-1960
Phone
(718) 743-7090
Fax
(718) 743-7337
NPI assigned
Feb 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 218207 NY Primary

Addresses

Primary practice location

1302 Kings Hwy
Brooklyn, NY 11229-1960

Mailing address

45 Falmouth St
Suite 2E
Brooklyn, NY 11235-3045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218207NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical, P.C. Gastroenterology PastSince Jul 20, 2000 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578607230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 FALMOUTH ST",
            "address_2": "SUITE 2E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291960",
            "telephone_number": "718-743-7090",
            "fax_number": "718-743-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERTSOVSKY",
        "first_name": "SVETLANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "218207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.