Active NPI
Nikita Tregubov, MD
- Internal Medicine Physician
- New City, NY
National Provider Identifier
1912901414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME84393
- Practice address
- 46 Amundsen Lane
New City, NY 10956 - Phone
- (845) 639-2480
- Fax
- (845) 639-2481
- NPI assigned
- Jun 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME84393 | FL | Primary |
Addresses
Primary practice location
46 Amundsen Lane
New City, NY 10956
Mailing address
46 Amundsen Lane
New City, NY 10956
Phone (845) 639-2480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME84393 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367884800000",
"number": "1912901414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 AMUNDSEN LANE",
"city": "NEW CITY",
"state": "NY",
"postal_code": "10956",
"telephone_number": "845-639-2480",
"fax_number": "845-639-2481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 AMUNDSEN LANE",
"city": "NEW CITY",
"state": "NY",
"postal_code": "10956",
"telephone_number": "845-639-2480",
"fax_number": "845-639-2481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREGUBOV",
"first_name": "NIKITA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2013-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME84393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.