Individual provider Active NPI

Greg Ribakove, M.D.

  • Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1750377388
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
152786 Issued in NY
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-7686
Fax
(718) 283-7392
NPI assigned
Sep 20, 2005
Last updated
Feb 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 152786 NY Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 152786 NY

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

PO Box 30060
New York, NY 10087-0060
Phone (718) 283-7686

Other identifiers 2

IdentifierTypeStateIssuer
01080244MedicaidNY
A400025191OtherNYMEDICARE PTAN

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
I20040412001233 NY Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 9537153606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Chicago, Pritzker School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-5433

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Maimonides Medical Center Maimonides Cardiothoracic Surgery Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Mar 1, 2010 Accepting new patients
MMC Division of General Thoracic Surgery F P P Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: gregribakove@mai.allscriptsdirect.net

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1750377388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30060",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870060",
            "telephone_number": "718-283-7686",
            "fax_number": "718-283-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-7686",
            "fax_number": "718-283-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIBAKOVE",
        "first_name": "GREG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "152786",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "152786",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01080244",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A400025191",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.