Organization Active NPI

Uni Health Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1740463546
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
226925 Issued in NY
Legal business name
UNI HEALTH MEDICAL PC
Practice address
1908 Avenue K
Brooklyn, NY 11230-4904
Phone
(718) 859-6786
Fax
(718) 859-6783
NPI assigned
Dec 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Authorized official

Name
Mrs. Andzhelika Kagzanova, DONPI 1265462931
Title
Solo Practician
Phone
(718) 859-6786

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 226925 NY Primary

Addresses

Primary practice location

1908 Avenue K
Brooklyn, NY 11230-4904

Mailing address

1908 Avenue K
Brooklyn, NY 11230-4904
Phone (718) 859-6786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051114001111 NY Part B Supplier - Clinic/Group Practice 3577582071 Receives reassigned benefits from 3 practitioners
Practice locations: Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1041902Uni Health Medical PC1908 Avenue K, Brooklyn, NY 11230Certificate of waiverJun 14, 2027

National Provider Directory

National Provider Directory

Locations

1908 Avenue K
Brooklyn, NY 11230
Phone (718) 859-6786

1916 Avenue N
#4
Brooklyn, NY 11230
Phone (718) 859-6786

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1740463546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 AVENUE K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304904",
            "telephone_number": "718-859-6786",
            "fax_number": "718-859-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 AVENUE K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304904",
            "telephone_number": "718-859-6786",
            "fax_number": "718-859-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNI HEALTH MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "KAGZANOVA",
        "authorized_official_first_name": "ANDZHELIKA",
        "authorized_official_title_or_position": "SOLO PRACTICIAN",
        "authorized_official_telephone_number": "718-859-6786",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "226925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.