Active NPI
Samira Ovshaev, D.O.
- Family Medicine Physician
- Brooklyn, NY
National Provider Identifier
1679518237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 219865
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0036153 | Medicaid | NJ | |
| 02263427 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061023000058 | NY | Practitioner - Family Practice | 2062488687 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 219865 | NY | MD | Licensed Practical Nurse |
| 25MB07600900 | NJ | MD | Family Medicine Physician |
Practice roles (5 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockland Family Medical Care P.C. | Current | Accepting new patients | |
| My Health Urgent Care PC | Current | Accepting new patients | |
| Samira Ovshaev DO PC | Family Medicine | Current | 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
- https://fhir4.healow.com/fhir/r4/GJEGAD
- 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.
-
- Urgent Care Clinic/Center
- Brooklyn, NY
- NPI 1750105375
-
- Primary Care Clinic/Center
- Monsey, NY
- NPI 1255508586
-
- Early Intervention Provider Agency
- Brooklyn, NY
- NPI 1871846667
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.