Individual provider Active NPI

Ekaterina Prokofieva

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1851913453
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403628 Issued in NY
Practice address
3235 Emmons Ave Apt 625
Brooklyn, NY 11235-1157
Phone
(718) 909-4842
NPI assigned
May 18, 2020
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403628 NY Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 674595-1 NY

Addresses

Primary practice location

3235 Emmons Ave Apt 625
Brooklyn, NY 11235-1157

Mailing address

3235 Emmons Ave Apt 625
Brooklyn, NY 11235-1157
Phone (718) 909-4842

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211123001667 NY Practitioner - Nurse Practitioner 5597154088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

750 Astor Ave
Bronx, NY 10467-9304
Phone (718) 882-5000

Merit-based Incentive Payment System (MIPS)

Final score
87.65 of 100Reported as group
Quality
71.56
Promoting interoperability
74
Improvement activities
40
Cost
87.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
674595-1NYMDPsychiatric/Mental Health Registered Nurse
403628NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family & Childrens Services Inc CurrentSince Oct 1, 2021 Accepting new patients
Jewish Board of Family and Children's Services, Inc. Psychiatric/Mental Health CurrentSince Oct 1, 2021 Accepting new patients

Locations

750 Astor Ave
Bronx, NY 10467
Phone (718) 882-5000

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

9777 Queens Blvd
Rego Park, NY 11374
Phone (718) 275-9300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1851913453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 EMMONS AVE APT 625",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112351157",
            "telephone_number": "718-909-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 EMMONS AVE APT 625",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112351157",
            "telephone_number": "718-909-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKOFIEVA",
        "first_name": "EKATERINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-18",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403628",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "674595-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.