NPIMap

Individual provider Active NPI

Boris Medarov, MD

  • Pulmonary Disease Physician
  • Albany, NY
National Provider Identifier
1720055098
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A105076 Issued in CA
Practice address
47 New Scotland Ave # a-91
Albany, NY 12208-3412
Phone
(518) 262-5196
NPI assigned
Mar 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 042836 CT
Pulmonary Disease Physician 207RP1001X 042836 CT
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A105076 CA
Pulmonary Disease Physician 207RP1001X A105076 CA Primary

Addresses

Primary practice location

47 New Scotland Ave # a-91
Albany, NY 12208-3412

Mailing address

47 New Scotland Ave # a-91
Albany, NY 12208-3412
Phone (518) 262-5196

Other identifiers 7

IdentifierTypeStateIssuer
1356390009OtherCAGROUP NPI
CE1617OtherCAGROUP RAILROAD MEDICARE
GR0100430OtherCAGROUP MEDICAL
1902846306OtherCAGROUP NPI
GROO16910OtherCAGROUP MEDICAID PIN
W11675OtherCAMEDICARE GROUP PIN
W18762OtherCAGROUP MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120619000318 NY Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 6507809472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine, Sleep Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

Hospital & facility affiliations

  • Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013
  • Southwestern Vermont Medical Center Hospital, Bennington, VT, CCN 470012
  • Columbia Memorial Hospital Hospital, Hudson, NY, CCN 330094
  • Rome Memorial Hospital, Inc Hospital, Rome, NY, CCN 330215
  • Aurelia Osborn Fox Memorial Hospital Hospital, Oneonta, NY, CCN 330085

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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

State licenses

LicenseStateTypeSpecialty
A105076CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Pulmonary Disease CurrentSince Aug 19, 2017 Accepting new patients
Albany Medical College CurrentSince Oct 2, 2019 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Aug 19, 2017 Accepting new patients
The Charlotte Hungerford Hospital Past Accepting new patients
Usc Internal Medicine, Inc. Pulmonary Disease Past Accepting new patients
Albany Medical Center Hospital Past Accepting new patients

Locations

1365 Washington Ave
Ste 200
Albany, NY 12206
Phone (518) 264-1761

47 New Scotland Ave
Ste 200
Albany, NY 12208

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

16 New Scotland Ave
Fl 2
Albany, NY 12208
Phone (518) 262-4942

47 New Scotland Ave
#A91
Albany, NY 12208
Phone (518) 262-5196

47 New Scotland Ave
#48
Albany, NY 12208
Phone (518) 262-0923

47 New Scotland Ave
#61
Albany, NY 12208
Phone (518) 262-5791

6 Medical Park Dr
Ste 203
Malta, NY 12020
Phone (518) 264-1200

1275 Broadway
Menands, NY 12204
Phone (518) 262-9705

Interoperability endpoints

  • Direct secure messaging: bmedarov27232@albanymed.direct-ci.com

Organizations & group practices 10

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1141430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1720055098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE # A-91",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE # A-91",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDAROV",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-04",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CT",
            "license": "042836",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "042836",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A105076",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A105076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1356390009",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP RAILROAD MEDICARE",
            "identifier": "CE1617",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAL",
            "identifier": "GR0100430",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1902846306",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID PIN",
            "identifier": "GROO16910",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "W11675",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "W18762",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.