Individual provider Active NPI

Dmitry Ostrovskiy, RPA-C

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1730462326
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
015047 Issued in NY
Practice address
2279 Coney Island Ave
Ste 2a
Brooklyn, NY 11223-3337
Phone
(171) 899-8989
NPI assigned
Sep 21, 2011
Last updated
Nov 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 015047 NY Primary

Addresses

Primary practice location

2279 Coney Island Ave
Ste 2a
Brooklyn, NY 11223-3337

Mailing address

2279 Coney Island Ave
Ste 2a
Brooklyn, NY 11223-3337
Phone (718) 998-9890

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120420000008 NY Practitioner - Physician Assistant 3779744636 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
015047NYMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Nes Medical Services of New York PC CurrentSince Nov 19, 2013 Accepting new patients
LR Medical PLLC CurrentSince Nov 1, 2015 Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1730462326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2279 CONEY ISLAND AVE",
            "address_2": "STE 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233337",
            "telephone_number": "718-998-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2279 CONEY ISLAND AVE",
            "address_2": "STE 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233337",
            "telephone_number": "171-899-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTROVSKIY",
        "first_name": "DMITRY",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-21",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.