Individual provider Active NPI

Olga Dvorkina, M.D.

  • Rheumatology Physician
  • Brooklyn, NY
National Provider Identifier
1639163835
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
208619-1 Issued in NY
Practice address
450 Clarkson Ave
Suite a
Brooklyn, NY 11203-2056
Phone
(718) 270-1662
Fax
(718) 270-1562
NPI assigned
Sep 2, 2005
Last updated
Nov 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 208619-1 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
Suite a
Brooklyn, NY 11203-2056

Mailing address

450 Clarkson Ave
Box 1262
Brooklyn, NY 11203-2056
Phone (718) 270-8867

Other identifiers 1

IdentifierTypeStateIssuer
02020675MedicaidNY

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
I20080918000000 NY Practitioner - Internal MedicinePractitioner - Rheumatology 9931276805 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208619-1NYMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. Current Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince Jan 1, 2022 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince Jan 1, 2022 Accepting new patients
University Physicians of Brooklyn, Inc. Rheumatology CurrentSince Jul 1, 1999 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Jul 1, 1999 Accepting new patients

Locations

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

450 Clarkson Ave
#1262
Brooklyn, NY 11203
Phone (718) 270-7379

450 Clarkson Ave
Ste A
Brooklyn, NY 11203
Phone (718) 270-1432

470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 826-4900

840 Lefferts Ave
Brooklyn, NY 11203
Phone (718) 493-0300

Interoperability endpoints

  • Direct secure messaging: olgadvorkina@sunydmc.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1639163835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-8867",
            "fax_number": "718-270-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "SUITE A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-1662",
            "fax_number": "718-270-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORKINA",
        "first_name": "OLGA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "208619-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02020675",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.