Boris S Pugachevsky, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

022292 Issued in NY

Practice address

1 Bay Club Dr
Apt.14-O
Bayside, NY 11360-2915

Phone

(917) 604-5403

NPI assigned

Jan 30, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• New Standards Physical Therapy, PC

  • Physical Therapist
  • Bayside, NY
  • NPI 1780127886
  NPD (past) Authorized official
• Integrated Quality Care Medical

  • Sports Medicine (Preventive Medicine) Physician
  • Flushing, NY
  • NPI 1144465584
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740327857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAY CLUB DR",
            "address_2": "APT.14-O",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602915",
            "telephone_number": "917-604-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY CLUB DR",
            "address_2": "APT.14-O",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602915",
            "telephone_number": "917-604-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGACHEVSKY",
        "first_name": "BORIS",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Foot & Ankle PC
• Premier Healthcare
• Carolyn Presky
• Karyn Ruth Price, LMSW
• Primary Care Associates, LLP
• Clins Puthussery Varghese
• Jimmy Qiu
• Mary Elizabeth Queally, REGISTERED NURSE
• Queens County Physical Therapy and Wellness,PC
• Queens Eyecare Physician PC

• Physical Therapist in Bayside, NY
• Providers in Bayside, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.