Individual provider Active NPI

Mikhail Abramovich Fuks, M.D.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1770579062
Registry record updated Jul 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
207032 Issued in NY
Practice address
150 Broadway
Suite 714
New York, NY 10038-4381
Phone
(212) 964-5555
Fax
(212) 964-0474
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 207032 NY Primary

Addresses

Primary practice location

150 Broadway
Suite 714
New York, NY 10038-4381

Mailing address

150 Broadway
Suite 714
New York, NY 10038-4381
Phone (212) 964-5555

Other identifiers 1

IdentifierTypeStateIssuer
01764112MedicaidNY

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
I20050111000189 NY Practitioner - Family Practice 3173571767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

150 Broadway
RM 714
New York, NY 10038-4334
Phone (212) 964-5555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207032NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unimed Health Care PC Family Medicine CurrentSince Sep 3, 1999 Accepting new patients

Locations

180 Broadway
Ste 401
New York, NY 10038
Phone (212) 964-5555

150 Broadway
Rm 714
New York, NY 10038
Phone (212) 964-5555

Networks

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

Organizations & group practices 1

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1770579062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BROADWAY",
            "address_2": "SUITE 714",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384381",
            "telephone_number": "212-964-5555",
            "fax_number": "212-964-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BROADWAY",
            "address_2": "SUITE 714",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384381",
            "telephone_number": "212-964-5555",
            "fax_number": "212-964-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKS",
        "first_name": "MIKHAIL",
        "middle_name": "ABRAMOVICH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "207032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01764112",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.