Individual provider Active NPI

Viktor Gribenko, MD

  • Physical Medicine & Rehabilitation Physician
  • Brooklyn, NY
National Provider Identifier
1659471944
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
211122 Issued in NY
Practice address
170 Avenue S
Brooklyn, NY 11223-2633
Phone
(718) 946-7967
Fax
(718) 946-7964
NPI assigned
Sep 25, 2006
Last updated
Oct 22, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 211122 NY Primary

Addresses

Primary practice location

170 Avenue S
Brooklyn, NY 11223-2633

Mailing address

9964 3Rd Ave
Brooklyn, NY 11209-7936
Phone (718) 748-8193

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

Practice roles

OrganizationSpecialtyStatusNew patients
Viktor Gribenko MD PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vig9076@direct.nyp.org

Organizations & group practices 2

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1659471944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9964 3RD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097936",
            "telephone_number": "718-748-8193",
            "fax_number": "718-946-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 AVENUE S",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112232633",
            "telephone_number": "718-946-7967",
            "fax_number": "718-946-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIBENKO",
        "first_name": "VIKTOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "211122",
            "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 Oct 22, 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.