Mikhail A Botvinov, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25MB08725300 Issued in NJ

Practice address

260 Old Hook Road,
Suite 303a
Westwood, NJ 07675-3123

Phone

(201) 778-5344

Fax

(201) 778-5399

NPI assigned

Jun 7, 2007

Last updated

Jun 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

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 2

Specialty

General Surgery

Education

New York College of Osteo Medicine of New York Institute of Technology, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wound Healing Associates PCGroup PAC ID 2668789116, 11 clinicians

White Plains Medical Diagnostic Services, PCGroup PAC ID 5395918932, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nyack Hospital Hospital, Nyack, NY, CCN 330104
• Hackensack Meridian Health Pascack Valley Medical Hospital, Westwood, NJ, CCN 310130
• Bergen New Bridge Medical Center Hospital, Paramus, NJ, CCN 310058

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

85.4

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: mbotvinov189451@ahs.direct-ci.com

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.

• Wound Healing Associates PC

  • Internal Medicine Physician
  • Hawthorne, NJ
  • NPI 1932585445
  Medicare reassignment Care Compare group NPD
• White Plains Medical Diagnostic Services, PC

  • Internal Medicine Physician
  • Nyack, NY
  • NPI 1689955338

  Surgery

  Medicare reassignment Care Compare group NPD
• Bergen Bariatric and Surgical Solutions PC

  • Surgery Physician
  • Westwood, NJ
  • NPI 1144730987
  Medicare reassignment Authorized official
• Heritage Wound Care LLC

  • Vascular Surgery Physician
  • Jersey City, NJ
  • NPI 1801447784
  Medicare reassignment NPD
• Mott Haven Professional Medical of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1922525781
  Medicare reassignment NPD
• Pons Physician Services, PLLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Cortland, NY
  • NPI 1457732554

  Surgery

  Medicare reassignment NPD
• Robert Marriott Medical Corp

  dba Advantage Wound Care

  • Surgery Physician
  • El Segundo, CA
  • NPI 1083883938

  NJ

  Medicare reassignment NPD
• Robert Marriott Medical Corp

  • Surgery Physician
  • Maywood, NJ
  • NPI 1003367558
  NPD
• New York City Healthcare Medical Services LLC

  • Vascular Surgery Physician
  • Brooklyn, NY
  • NPI 1487489688
  NPD
• Vascular Anesthesia Associates PLLC

  dba Vascular Anesthesia Associates

  • Certified Registered Nurse Anesthetist
  • Houston, TX
  • NPI 1346706173
  NPD (past)
• Washington Heights Medical of New York LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • New York, NY
  • NPI 1417340134
  NPD (past)

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

• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1689682999
  Care Compare affiliation
• Pascack Valley Hospital LLC

  dba HackensackUMC at Pascack Valley

  • General Acute Care Hospital
  • Westwood, NJ
  • NPI 1205176062
  Care Compare affiliation
• Montefiore Nyack Hospital

  • General Acute Care Hospital
  • Nyack, NY
  • NPI 1104808062
  Care Compare affiliation

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1760685622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ROBYN CT",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301464",
            "telephone_number": "201-693-2653",
            "fax_number": "201-778-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 OLD HOOK ROAD,",
            "address_2": "SUITE 303A",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753123",
            "telephone_number": "201-778-5344",
            "fax_number": "201-778-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTVINOV",
        "first_name": "MIKHAIL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MB08725300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Heron Vitality LLC
• Jonathan E Blume, M.D.
• Kaylee Jordan Bockhorn, M.S., CCC-SLP
• Teresa Rose Boemio, MS
• Andrew Michael Boruta, DO
• Mina Boulos, M.D., D.M.D.
• Laurie A Bovino, DMD
• Bray Orthotics and Prosthetics LLC
• Breast Fit
• Breast Rehabilitation & Healing Center

• Surgery Physician in Westwood, NJ
• Providers in Westwood, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.