Kaylan Pustover, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

293128 Issued in NY

Practice address

4 W 58TH St FL 13
New York, NY 10019-2515

Phone

(212) 431-4749

NPI assigned

Jul 31, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Dermatology

Education

Lake Erie College of Osteopathic Medicine, Erie, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hudson Dermatology, PCGroup PAC ID 8022021732, 40 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: kpustover@navaderm.emadirect.md

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.

• Hudson Dermatology, PC

  • Dermatology Physician
  • Fishkill, NY
  • NPI 1508895384
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1871901918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 W 58TH ST FL 13",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W 58TH ST FL 13",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192515",
            "telephone_number": "212-431-4749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5333 McAuley Dr",
            "address_2": "Suite 5003",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481971014",
            "country_code": "US",
            "telephone_number": "734-712-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUSTOVER",
        "first_name": "KAYLAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "293128",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5101021933",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY LICENSE",
            "identifier": "293128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Purzue Care Inc
• Larisa Pushkar, LMSW
• Pushpa Chauhan D.P.M.
• Caroline H Puskas
• Susan Pustilnik
• Jennifer Pusztay
• Maria Putilina
• Claire Putman
• Isaiah David Putman
• Megan Anne Putnam, PH.D.

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.