Individual provider Active NPI

Edidiye Arbov, MD

  • Psychiatry Physician
  • Rego Park, NY
National Provider Identifier
1750665139
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
262139 Issued in NY
Practice address
6614 Saunders St
Rego Park, NY 11374-4637
Phone
(718) 915-0717
NPI assigned
Oct 4, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 262139 NY Primary

Addresses

Primary practice location

6614 Saunders St
Rego Park, NY 11374-4637

Mailing address

6614 Saunders St
Rego Park, NY 11374-4637
Phone (718) 915-0717

Other identifiers 1

IdentifierTypeStateIssuer
03398143MedicaidNY

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
I20111107000454 NY Practitioner - Psychiatry 5193998201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9932 66TH Rd
Suite LP
Rego Park, NY 11374-4401
Phone (718) 915-0717

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
262139NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Art of Medical Care, PC Psychiatry CurrentSince Apr 8, 2015 Accepting new patients
Nys Office of Mental Health Past Accepting new patients

Locations

9932 66th Rd
Ste Lp
Rego Park, NY 11374
Phone (718) 459-8900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1750665139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 SAUNDERS ST",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744637",
            "telephone_number": "718-915-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 SAUNDERS ST",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744637",
            "telephone_number": "718-915-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARBOV",
        "first_name": "EDIDIYE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-04",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "262139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03398143",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.