Individual provider Active NPI

Aviva Leibovitz

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1750924445
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
260 Avenue X
Brooklyn, NY 11223-5940
Phone
(718) 336-8855
NPI assigned
Oct 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY Primary

Addresses

Primary practice location

260 Avenue X
Brooklyn, NY 11223-5940

Mailing address

260 Avenue X
Brooklyn, NY 11223-5940
Phone (718) 336-8855

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210429001195 NY Practitioner - Physician Assistant 8325457559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un Col of Osteopathic Medicine, New York, 2019
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)

180 Myrtle Ave
Brooklyn, NY 11201-7059
Phone (718) 650-2233

260 Ave X
Brooklyn, NY 11223-5940
Phone (718) 336-8855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Suny Downstate Medical Center PastSince Nov 6, 2022 Accepting new patients

Networks

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

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": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1750924445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 AVENUE X",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235940",
            "telephone_number": "718-336-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 AVENUE X",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235940",
            "telephone_number": "718-336-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOVITZ",
        "first_name": "AVIVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.