Individual provider Active NPI

Olga A Dioukalova, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1609868785
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
214274 Issued in NY
Practice address
1915 Ocean Ave
1St Floor
Brooklyn, NY 11230-6801
Phone
(718) 951-0333
Fax
(718) 951-3774
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 214274 NY Primary
Internal Medicine Physician 207R00000X ME81796 FL

Addresses

Primary practice location

1915 Ocean Ave
1St Floor
Brooklyn, NY 11230-6801

Mailing address

1915 Ocean Ave
1St Floor
Brooklyn, NY 11230-6801
Phone (718) 951-0333

Other identifiers 1

IdentifierTypeStateIssuer
01977628MedicaidNY

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
I20061121000745 NY Practitioner - Internal Medicine 3870591134 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maimonides Faculty Practice PlanGroup PAC ID 7012808348, 251 clinicians

Practice addresses (Care Compare)

1401 Newkirk Ave
Brooklyn, NY 11226-6521
Phone (718) 283-8773

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME81796FLMDInternal Medicine Physician
214274NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Faculty Practice Plan Internal Medicine CurrentSince Jul 1, 2000 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Maimonides Medical Center Maimonides Primary Care FPP Internal Medicine CurrentSince Jul 1, 1999 Accepting new patients
Brooklyn Medical Associates, PLLC PastSince Apr 30, 2003 Accepting new patients

Locations

4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

1401 Newkirk Ave
Brooklyn, NY 11226
Phone (718) 283-1600

1250 57th St
Brooklyn, NY 11219
Phone (718) 283-5700

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: olgadioukalova@mai.allscriptsdirect.net
  • Direct secure messaging: olga.dioukalova.p1@direct.mmc.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1609868785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 OCEAN AVE",
            "address_2": "1ST FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306801",
            "telephone_number": "718-951-0333",
            "fax_number": "718-951-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 OCEAN AVE",
            "address_2": "1ST FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306801",
            "telephone_number": "718-951-0333",
            "fax_number": "718-951-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIOUKALOVA",
        "first_name": "OLGA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "214274",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME81796",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01977628",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.