Individual provider Active NPI

Boris Markovich, M.D.

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1710065602
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
236762 Issued in NY
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-6031
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 236762 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

759 Turf Rd
Valley Stream, NY 11581-3505
Phone (917) 710-1400

Other identifiers 1

IdentifierTypeStateIssuer
02677443MedicaidNY

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
I20050915000765 NY Practitioner - Emergency Medicine 8628001096 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236762NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dobbs Ferry Emergency Medicine, PC Emergency Medicine CurrentSince Jan 1, 2013 Accepting new patients
St Lukes Roosevelt Hospital Center Emergency Medicine Past Accepting new patients
Paragon Emergency Medical Care, PC Emergency Medicine Past Accepting new patients
Maimonides Medical Center - MMC Emergency Physicians FPP Emergency Medicine Past Accepting new patients

Locations

128 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 245-8936

967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956

Organizations & group practices 4

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710065602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 TURF RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813505",
            "telephone_number": "917-710-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKOVICH",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "236762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02677443",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.