Individual provider Active NPI

Gerald J Popkin, D.D.S.

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1649297136
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
033258 Issued in NY
Practice address
1623 3Rd Ave
Suite 204
New York, NY 10128-3638
Phone
(212) 722-4088
Fax
(212) 722-2409
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 033258 NY Primary

Addresses

Primary practice location

1623 3Rd Ave
Suite 204
New York, NY 10128-3638

Mailing address

1623 3Rd Ave
Suite 204
New York, NY 10128-3638
Phone (212) 722-4088

Other identifiers 1

IdentifierTypeStateIssuer
00295950MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150526000210 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9032439534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033258NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sherwin Benlevi DDS PC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1649297136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 3RD AVE",
            "address_2": "SUITE 204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283638",
            "telephone_number": "212-722-4088",
            "fax_number": "212-722-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 3RD AVE",
            "address_2": "SUITE 204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283638",
            "telephone_number": "212-722-4088",
            "fax_number": "212-722-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPKIN",
        "first_name": "GERALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "033258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00295950",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.