Igor Brichkov, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

25MA09854200 Issued in NJ

Practice address

264 Greencroft Ave
Staten Island, NY 10308-3247

Phone

(646) 342-0379

NPI assigned

Jan 4, 2008

Last updated

Mar 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Thoracic SurgeryAlso: General Surgery

Education

Albany Medical College of Union University, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centrastate Medical Center Hospital, Freehold, NJ, CCN 310111

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: igorbrichkov@mai.allscriptsdirect.net

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.

• Practice Associates Medical Group

  dba Atlantic Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385
  Medicare reassignment Care Compare group NPD
• MMC Division of General Thoracic Surgery F P P

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Brooklyn, NY
  • NPI 1508969494
  Medicare reassignment NPD
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• Coney Island Medical Practice Plan, P.C.

  • General Practice Physician
  • Brooklyn, NY
  • NPI 1386951762
  NPD (past)
• Maimonides Medical Center Maimonides Cardiothoracic Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Brooklyn, NY
  • NPI 1104929090
  NPD (past)
• University Group Medical Associates, P.C

  dba Coney Island Medical Group

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1285683102

  Surgery

  NPD (past)

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

• Centrastate Medical Center, Inc

  • General Acute Care Hospital
  • Freehold, NJ
  • NPI 1295718450
  Care Compare affiliation

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1710162193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 GREENCROFT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103083247",
            "telephone_number": "646-342-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 GREENCROFT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103083247",
            "telephone_number": "646-342-0379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Route 37 W Ste 6",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087536500",
            "country_code": "US",
            "telephone_number": "732-698-8935",
            "fax_number": "732-431-1848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 W Main St Ste G1",
            "address_purpose": "LOCATION",
            "city": "Freehold",
            "state": "NJ",
            "postal_code": "077282537",
            "country_code": "US",
            "telephone_number": "732-698-8935",
            "fax_number": "732-431-1848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 Route 130 Ste 29B",
            "address_purpose": "LOCATION",
            "city": "East Windsor",
            "state": "NJ",
            "postal_code": "085202735",
            "country_code": "US",
            "telephone_number": "732-698-8935",
            "fax_number": "732-431-1848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRICHKOV",
        "first_name": "IGOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-04",
        "last_updated": "2024-03-11",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "245236",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA09854200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chaya Breuer
• Autumn Breutzmann, DO
• Svetlana Breycher
• Brian a Maloney M D P C
• Briana Rispoli LLC
• Palladii Brichkov
• Bridge Back to Life Center, Inc.
• Bridge Back to Life, Inc.
• Bridge Back to Life, Inc.
• Bridge Licensed Behavior Analysis PLLC

• Vascular Surgery Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Vascular Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.

Verify at the official NPI Registry.