Individual provider Active NPI

Samira Ovshaev, D.O.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1679518237
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
219865 Issued in NY
Practice address
8717 21St Ave
Suite 1C
Brooklyn, NY 11214-4951
Phone
(718) 266-9779
Fax
(718) 266-3262
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 219865 NY Primary
Family Medicine Physician 207Q00000X 25MB07600900 NJ

Addresses

Primary practice location

8717 21St Ave
Suite 1C
Brooklyn, NY 11214-4951

Mailing address

40 Oceana Dr W
Apt.5G
Brooklyn, NY 11235-6665
Phone (718) 266-9779

Other identifiers 2

IdentifierTypeStateIssuer
0036153MedicaidNJ
02263427MedicaidNY

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
I20061023000058 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative MedicinePractitioner - Pain Management 2062488687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine, Pain Management
Education
New York College of Osteo Medicine of New York Institute of Technology, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4010 Ave J
Brooklyn, NY 11210-4440
Phone (718) 266-9779

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219865NYMDLicensed Practical Nurse
25MB07600900NJMDFamily Medicine Physician

Practice roles (5 of 8)

OrganizationSpecialtyStatusNew patients
Rockland Family Medical Care P.C. CurrentSince Jun 1, 2015 Accepting new patients
My Health Urgent Care PC CurrentSince Nov 17, 2024 Accepting new patients
Samira Ovshaev DO PC Family Medicine CurrentSince Nov 17, 2020 Accepting new patients
Ege PT PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4010 Avenue J
#1
Brooklyn, NY 11210
Phone (718) 266-9779

4010 Avenue J
Brooklyn, NY 11210
Phone (718) 266-9779

6 Melnick Dr
Ste 101
Monsey, NY 10952
Phone (845) 352-9292

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJEGAD
  • FHIR API: https://fhir4.healow.com/fhir/r4/GGCGBD/Endpoint/GGCGBD

Organizations & group practices 6

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1679518237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 OCEANA DR W",
            "address_2": "APT.5G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356665",
            "telephone_number": "718-266-9779",
            "fax_number": "718-266-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8717 21ST AVE",
            "address_2": "SUITE 1C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144951",
            "telephone_number": "718-266-9779",
            "fax_number": "718-266-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVSHAEV",
        "first_name": "SAMIRA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "219865",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB07600900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036153",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02263427",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.