Individual provider Active NPI

Ekaterina Semenova

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1801276191
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
295756 Issued in NY
Practice address
310 E 14TH St
New York, NY 10003-4284
Phone
(212) 979-4000
Fax
(212) 979-4430
NPI assigned
Jun 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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
Ophthalmology Physician 207W00000X 295756 NY Primary

Addresses

Primary practice location

310 E 14TH St
New York, NY 10003-4284

Mailing address

310 E 14TH St
New York, NY 10003-4284
Phone (212) 979-4000

Other practice location 1

355 Bard Ave
Staten Island, NY 10310-1664
Phone (917) 251-4848

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
I20190729002698 NY Practitioner - Ophthalmology 8022354299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

17 E 102ND St 8TH FL
Ophthalmology Department of Mount
New York, NY 10029-5204
Phone 212241811848118

Hospital & facility affiliations

  • Ny Eye and Ear Infirmary of Mount Sinai Hospital, New York, NY, CCN 330100
  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295756NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Ophthalmology CurrentSince Sep 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Ophthalmology CurrentSince Sep 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

310 E 14th St
New York, NY 10003
Phone (212) 979-4000

17 E 102nd St
Fl 8
New York, NY 10029
Phone (212) 241-0939

310 E 14th St
Ste 319
New York, NY 10003
Phone (212) 979-4500

218 2nd Ave
New York, NY 10003
Phone (212) 979-4000

77 Worth St
Frnt 1
New York, NY 10013
Phone (212) 257-6900

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

Networks

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

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1801276191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034284",
            "telephone_number": "212-979-4000",
            "fax_number": "212-979-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034284",
            "telephone_number": "212-979-4000",
            "fax_number": "212-979-4430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Bard Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103101664",
            "country_code": "US",
            "telephone_number": "917-251-4848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEMENOVA",
        "first_name": "EKATERINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "295756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.