Individual provider Active NPI

Afshin Tavakoly, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1700059680
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
247938 Issued in NY
Practice address
1664 E 14TH St Ste 101
Brooklyn, NY 11229-1162
Phone
(718) 998-2350
NPI assigned
Apr 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 247938 NY Primary

Addresses

Primary practice location

1664 E 14TH St Ste 101
Brooklyn, NY 11229-1162

Mailing address

623 Middle Neck Rd
Great Neck, NY 11023-1245
Phone (917) 605-7233

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
I20100311000806 NY Practitioner - Internal Medicine 0749315059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corona Medical PCGroup PAC ID 0749421279, 3 clinicians

Practice addresses (Care Compare)

623 Middle Neck Rd
Great Neck, NY 11023-1245
Phone (718) 426-8100

Hospital & facility affiliations

  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Merit-based Incentive Payment System (MIPS)

Final score
95.93 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
69.76

National Provider Directory

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

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: atavakoly15456@nychhc.direct-ci.com
  • Direct secure messaging: afshin.tavakoly@aimcl.eclinicaldirectplus.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1700059680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 MIDDLE NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231245",
            "telephone_number": "917-605-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 E 14TH ST STE 101",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291162",
            "telephone_number": "718-998-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKOLY",
        "first_name": "AFSHIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "247938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.