Organization Active NPI

Gennady Ukrainsky MD PC

  • Otolaryngology Physician
  • Forest Hills, NY
National Provider Identifier
1841486545
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
GENNADY UKRAINSKY MD PC
Practice address
108-12 72ND Ave
3Rd Floor
Forest Hills, NY 11375-7080
Phone
(718) 544-9300
Fax
(718) 544-9301
NPI assigned
Sep 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Authorized official

Name
Emily Lam
Title
Credentialing
Phone
(914) 471-3422

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X NY Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

108-12 72ND Ave
3Rd Floor
Forest Hills, NY 11375-7080

Mailing address

PO Box 2625
New York, NY 10009-8925
Phone (914) 471-3422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090305000441 NY Part B Supplier - Clinic/Group Practice 9436215092 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY; Forest Hills, NY

National Provider Directory

National Provider Directory

Locations

10812 72nd Ave
Ste 3
Forest Hills, NY 11375
Phone (718) 384-6933

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1841486545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2625",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100098925",
            "telephone_number": "914-471-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108-12 72ND AVE",
            "address_2": "3RD FLOOR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757080",
            "telephone_number": "718-544-9300",
            "fax_number": "718-544-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENNADY UKRAINSKY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "LAM",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "914-471-3422"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.