Yuriy Olegovich Ivanov, DO

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

1790026011 Issued in NJ

Practice address

125 Paterson St
New Brunswick, NJ 08901-1962

Phone

(732) 235-7661

Fax

(732) 235-7246

NPI assigned

Mar 12, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 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

Osteopathic Manipulative Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rutgers Health-RWJ Pediatric Critical CareGroup PAC ID 1355390287, 153 clinicians

Rutgers Health-RWJ Scleroderma ProgramGroup PAC ID 5193764991, 390 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038
• Robert Wood Johnson University Hospital - Somerset Hospital, Somerville, NJ, CCN 310048

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: yivanov845452@nychhc.direct-ci.com
• Direct secure messaging: yuriyivanov@nslijmedgr.allscriptsdirect.net

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.

• Rutgers Health-RWJ Pediatric Critical Care

  • Family Medicine Physician
  • New Brunswick, NJ
  • NPI 1780766527

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Rutgers Health-RWJ Scleroderma Program

  • Allergy & Immunology (Internal Medicine) Physician
  • New Brunswick, NJ
  • NPI 1679655781

  Single Specialty

  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Single Specialty

  Medicare reassignment NPD
• Universal Pain Management,PC

  • Interventional Pain Medicine Physician
  • Astoria, NY
  • NPI 1548545841

  Single Specialty

  Medicare reassignment NPD
• Rutgers Health-RWJ Pediatric Critical Care

  • Neonatal-Perinatal Medicine Physician
  • New Brunswick, NJ
  • NPI 1295741858

  Single Specialty

  NPD
• Rutgers Health-RWJ Scleroderma Program

  • Psychiatry Physician
  • Piscataway, NJ
  • NPI 1033207378

  Single Specialty

  NPD
• Rutgers Health-RWJ Scleroderma Program

  • Pediatric Endocrinology Physician
  • New Brunswick, NJ
  • NPI 1457372104

  Single Specialty

  NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• Rutgers Health-RWJ Pediatric Critical Care

  • Pediatric Critical Care Medicine Physician
  • New Brunswick, NJ
  • NPI 1164510400
  NPD (past)
• Rutgers Health-RWJ Scleroderma Program

  • Allergy & Immunology Physician
  • New Brunswick, NJ
  • NPI 1619059011

  Single Specialty

  NPD (past)
• Universal Pain Management,PC

  • Physical Therapist
  • Astoria, NY
  • NPI 1699152934
  NPD (past)

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

• Robert Wood Johnson University Hospital Inc

  • General Acute Care Hospital
  • Somerville, NJ
  • NPI 1003236878
  Care Compare affiliation
• Robert Wood Johnson University Hospital, Inc

  • General Acute Care Hospital
  • New Brunswick, NJ
  • NPI 1346243375
  Care Compare affiliation

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1790026011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1554 NORTHERN BLVD FL 4",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303053",
            "telephone_number": "516-321-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-7661",
            "fax_number": "732-235-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1554 Northern Blvd Bldg Floor4",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303053",
            "country_code": "US",
            "telephone_number": "516-321-6410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVANOV",
        "first_name": "YURIY",
        "middle_name": "OLEGOVICH",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-12",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": "276396",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NJ",
            "license": "1790026011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hesbon Isaboke, MD
• Kerelos Magdy Isac, MD
• Sara Isani, MD
• Jacob Ishakis
• Assylzhan Issakhanova, M.D.
• Deepa B Iyer, MD
• Salma Jabbour
• Keren Jackson, MD
• Sheryl Jackson
• David Jacob, MD

• Pain Medicine Physician in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Pain Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.