Olena Ksovreli, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

221578 Issued in NY

Practice address

Health Sciences Ctr
Stony Brook University
Stony Brook, NY 11794-8160

Phone

(631) 444-8478

Fax

(631) 444-7546

NPI assigned

Feb 21, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Calvary Hospital IncGroup PAC ID 9133010382, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Calvary Hospital Inc

  • Special Hospital
  • Bronx, NY
  • NPI 1003858390
  Medicare reassignment Care Compare group NPD
• New York University

  dba NYU Faculty Group Practice

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  Internal Medicine, NY

  Medicare reassignment NPD
• Calvary Hospital Inc

  • Long Term Care Hospital
  • Bronx, NY
  • NPI 1528495306
  NPD
• New York University

  dba NYU Langone Ambulatory Care Chelsea

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613

  Internal Medicine

  NPD
• Stony Brook Surgical Associates, University Faculty Practice Corporati

  • Surgery Physician
  • Stony Brook, NY
  • NPI 1063468536
  NPD (past)

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1821063041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1554",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900988",
            "telephone_number": "631-444-0650",
            "fax_number": "631-638-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HEALTH SCIENCES CTR",
            "address_2": "STONY BROOK UNIVERSITY",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948160",
            "telephone_number": "631-444-8478",
            "fax_number": "631-444-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KSOVRELI",
        "first_name": "OLENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "221578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02177879",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF CONSUMER PROTECTION",
            "identifier": "CSP 0044740",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENCE",
            "identifier": "047041",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "221578",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harrison Richard Kronfeld, DO
• Allison K Kruger, MD, MPH
• Irvin Krukenkamp, M.D.
• Yana Krutoshinskaya, M.D.
• Halyna Krylyuk, MD
• Elias Ku
• Betty Kuang
• Allan Jeffrey Kucine, DDS
• Andrzej Kudelka, M.D.
• Regina Leilani Kuhia, MD

• Internal Medicine Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.