Individual provider Active NPI

Svetlin S Ivanov, MD

  • Obstetrics & Gynecology Physician
  • Mineola, NY
National Provider Identifier
1891783130
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
235678 1 Issued in NY
Practice address
120 Mineola Blvd
Suite 100
Mineola, NY 11501-4064
Phone
(516) 663-3010
Fax
(516) 663-3026
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 235678 1 NY Primary

Addresses

Primary practice location

120 Mineola Blvd
Suite 100
Mineola, NY 11501-4064

Mailing address

120 Mineola Blvd
Suite 100
Mineola, NY 11501-4064
Phone (516) 663-3010

Other identifiers 1

IdentifierTypeStateIssuer
02762783MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sivanov222102@nyumc.direct-ci.com

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
I20050719000985 NY Practitioner - Obstetrics/Gynecology 3072540244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235678 1NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University Obstetrics & Gynecology CurrentSince Oct 1, 2018 Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients
Bethpage OB/GYN, P.C. Past Accepting new patients
Square Care Medical Group, LLP Obstetrics & Gynecology PastSince Jul 22, 2013 Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

1111 Franklin Ave
Garden City, NY 11530
Phone (516) 222-8600

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

120 Mineola Blvd
Ste 100
Mineola, NY 11501
Phone (516) 663-2010

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15987/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sivanov222102@nyumc.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1891783130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 100",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014064",
            "telephone_number": "516-663-3010",
            "fax_number": "516-663-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 100",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014064",
            "telephone_number": "516-663-3010",
            "fax_number": "516-663-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOV",
        "first_name": "SVETLIN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "235678 1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02762783",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sivanov222102@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "120 Mineola Blvd",
            "address_2": "Suite 100",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115014064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.