Individual provider Active NPI

Avichai Dukshtein, MD

  • Anesthesiology Physician
  • Brooklyn, NY
National Provider Identifier
1770849119
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
000279800 Issued in NY
Practice address
4802 10TH Ave
Maimonides Medical Center
Brooklyn, NY 11219-2916
Phone
(718) 283-6000
NPI assigned
Apr 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 000279800 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Maimonides Medical Center
Brooklyn, NY 11219-2916

Mailing address

55 Oceana Dr E Apt 4a
Brooklyn, NY 11235-6696
Phone (347) 413-4845

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
I20151113000226 NY Practitioner - Anesthesiology 1759691256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8340 Woodhaven Blvd
Glendale, NY 11385-7824
Phone (718) 849-8700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000279800NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emusc, LLC CurrentSince Apr 1, 2018 Accepting new patients
Emusc, LLC Current Accepting new patients
Anesthesiology Associates of Boro Park, LLP Anesthesiology CurrentSince Sep 1, 2017 Accepting new patients
Emusc, LLC Anesthesiology CurrentSince Apr 1, 2018 Accepting new patients
Maimonides Department of Psychiatry FPP Past Accepting new patients

Locations

4802 10th Ave
#C
Brooklyn, NY 11219
Phone (718) 283-8163

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

5925 Kissena Blvd
Flushing, NY 11355
Phone (718) 280-9788

8340 Woodhaven Blvd
Glendale, NY 11385
Phone (718) 441-0101

Networks

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

Organizations & group practices 5

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1770849119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 OCEANA DR E APT 4A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356696",
            "telephone_number": "347-413-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "address_2": "MAIMONIDES MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKSHTEIN",
        "first_name": "AVICHAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "000279800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.