Organization Active NPI

Tatyana Semenova Physician P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
National Provider Identifier
1790397891
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TATYANA SEMENOVA PHYSICIAN P.C.
Practice address
626 Sheepshead Bay Rd Ste 530
Brooklyn, NY 11224-3606
Phone
(347) 277-9084
NPI assigned
Aug 19, 2020
Last updated
Aug 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Authorized official

Name
Tatyana Semenova, MDNPI 1437431269
Title
President
Phone
(347) 277-9084

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

626 Sheepshead Bay Rd Ste 530
Brooklyn, NY 11224-3606

Mailing address

2258 84TH St
Brooklyn, NY 11214-3383
Phone (347) 277-9084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201211001136 NY Part B Supplier - Clinic/Group Practice 2466864657 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

626 Sheepshead Bay Rd
Ste 530
Brooklyn, NY 11224
Phone (347) 277-9084

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1790397891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2258 84TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143383",
            "telephone_number": "347-277-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 SHEEPSHEAD BAY RD STE 530",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112243606",
            "telephone_number": "347-277-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TATYANA SEMENOVA PHYSICIAN P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "SEMENOVA",
        "authorized_official_first_name": "TATYANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-277-9084",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.