Individual provider Active NPI

Nadezhda Badalova, MD

  • Internal Medicine Physician
  • Long Island City, NY
National Provider Identifier
1770769531
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
245373 Issued in NY
Practice address
3711 Queens Blvd
Long Island City, NY 11101-1725
Phone
(718) 361-5100
Fax
(718) 361-5169
NPI assigned
Jan 11, 2008
Last updated
Jan 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 245373 NY Primary

Addresses

Primary practice location

3711 Queens Blvd
Long Island City, NY 11101-1725

Mailing address

3711 Queens Blvd
Long Island City, NY 11101-1725
Phone (718) 361-5100

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
I20160107002940 NY Practitioner - Internal Medicine 1254517667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

733 Sunrise Hwy
Lynbrook, NY 11563-2921
Phone (516) 734-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
245373NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jan 15, 2022 Accepting new patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Jan 15, 2022 Accepting new patients
North Shore - Lij Internal Medicine at Lynbrook PC Internal Medicine Past Accepting new patients

Locations

733 Sunrise Hwy
Lynbrook, NY 11563
Phone (516) 593-3535

733 Sunrise Hwy
Fl 3
Lynbrook, NY 11563
Phone (516) 593-3541

300 Community Dr
Manhasset, NY 11030

Networks

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

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": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1770769531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 QUEENS BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111011725",
            "telephone_number": "718-361-5100",
            "fax_number": "718-361-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 QUEENS BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111011725",
            "telephone_number": "718-361-5100",
            "fax_number": "718-361-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADALOVA",
        "first_name": "NADEZHDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "245373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.