Individual provider Active NPI

Natalya Tkachenko, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1740491927
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
243907 Issued in NY
Practice address
1090 Amsterdam Ave
4TH FL
New York, NY 10025-1737
Phone
(212) 961-5500
NPI assigned
May 27, 2007
Last updated
Jan 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 243907 NY Primary

Addresses

Primary practice location

1090 Amsterdam Ave
4TH FL
New York, NY 10025-1737

Mailing address

69 Tiemann PL Apt 21
New York, NY 10027-3355
Phone (917) 536-8969

Other identifiers 1

IdentifierTypeStateIssuer
02898057MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070802000556 NY Practitioner - Internal Medicine 4688765852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Stony Brook, School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

827 11TH Ave
New York, NY 10019-3535
Phone (212) 369-5566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
243907NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc CurrentSince Aug 1, 2024 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients
Murray Hill Medical Group PC PastSince Jun 1, 1992 Accepting new patients

Locations

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

770 Flatbush Ave
Brooklyn, NY 11226
Phone (347) 627-3988

2315 3rd Ave
New York, NY 10035
Phone (212) 369-5566

827 11th Ave
New York, NY 10019
Phone (212) 257-9778

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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": "1180224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1740491927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 TIEMANN PL APT 21",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100273355",
            "telephone_number": "917-536-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE",
            "address_2": "4TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737",
            "telephone_number": "212-961-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACHENKO",
        "first_name": "NATALYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-27",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "243907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02898057",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.