Individual provider Active NPI

Boleslav Kosharskyy, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Bronx, NY
National Provider Identifier
1922081264
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
234893 Issued in NY
Practice address
3400 Bainbridge Avenue Suite Ll400
Bronx, NY 10467-2404
Phone
(718) 920-7246
Fax
(718) 652-4018
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 234893 NY Primary
Anesthesiology Physician 207L00000X 25MA08645800 NJ

Addresses

Primary practice location

3400 Bainbridge Avenue Suite Ll400
Bronx, NY 10467-2404

Mailing address

90 Matawan Rd Ste 302
Matawan, NJ 07747-2653
Phone (732) 441-7177

Other practice location 1

596 Anderson Ave Ste 216
Cliffside Park, NJ 07010-1856
Phone (201) 772-2329

Other identifiers 1

IdentifierTypeStateIssuer
02660364MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050608001211 NY Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 3476596503 Reassigns benefits to 4 organizations
I20110217000504 NJ Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 3476596503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management, Pain Management
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BL Pain Management PLLCGroup PAC ID 2062776040, 4 clinicians

Practice addresses (Care Compare)

9618 63Rd Dr
Suite 202
Rego Park, NY 11374-2239
Phone (718) 459-9999

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234893NYMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siuc Medical PC CurrentSince Feb 17, 2020 Accepting new patients
Premier Brain and Spine, LLC CurrentSince Mar 1, 2026 Accepting new patients
Big Leap Medical Group PA Anesthesiology CurrentSince Nov 1, 2024 Accepting new patients
Premier Brain and Spine LLC CurrentSince Mar 1, 2026 Accepting new patients
Montefiore Medical Center Anesthesiology CurrentSince May 22, 2017 Accepting new patients
BL Pain Management PLLC CurrentSince Mar 1, 2018 Accepting new patients
BL Pain Management PLLC CurrentSince Mar 1, 2018 Accepting new patients
Montefiore Medical Center CurrentSince May 22, 2017 Accepting new patients
Fpa Hospital Based Past Accepting new patients
Ramapo Anesthesiologists, PC Anesthesiology PastSince Mar 5, 2007 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Pain Physicians Ny PLLC PastSince Jun 13, 2017 Accepting new patients
LR Medical PLLC Past Accepting new patients

Locations

596 Anderson Ave
Ste 216
Cliffside Pk, NJ 07010
Phone (201) 772-2329

90 Matawan Rd
Ste 302
Matawan, NJ 07747
Phone (201) 972-5568

2500 Morris Ave
Ste 220
Union, NJ 07083
Phone 7329069600312

1001 Laurel Oak Rd
Ste A2
Voorhees, NJ 08043
Phone (856) 566-8600

2325 31st St
Ste 400
Astoria, NY 11105
Phone (332) 334-1511

1976 Crotona Pkwy
Ste 3A
Bronx, NY 10460
Phone (718) 459-9999

1976 Crotona Pkwy
Fl 4
Bronx, NY 10460

326 E 149th St
Bronx, NY 10451
Phone (718) 585-6100

111 E 210th St
Bronx, NY 10467

1976 Crotona Pkwy
Bronx, NY 10460
Phone (332) 334-1511

775 Park Ave
Ste 115
Huntington, NY 11743
Phone (631) 659-4150

295 Madison Ave
Rm 407
New York, NY 10017
Phone (332) 334-1511

240 E 23rd St
New York, NY 10010
Phone (212) 757-0222

169 Madison Ave
Ste 2828
New York, NY 10016
Phone (332) 330-4076

9618 63rd Dr
Ste 202
Rego Park, NY 11374
Phone (718) 459-9999

Networks

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

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1922081264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MATAWAN RD STE 302",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472653",
            "telephone_number": "732-441-7177",
            "fax_number": "732-441-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVENUE SUITE LL400",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-7246",
            "fax_number": "718-652-4018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "596 Anderson Ave Ste 216",
            "address_purpose": "LOCATION",
            "city": "Cliffside Park",
            "state": "NJ",
            "postal_code": "070101856",
            "country_code": "US",
            "telephone_number": "201-772-2329",
            "fax_number": "212-757-0223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSHARSKYY",
        "first_name": "BOLESLAV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "234893",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA08645800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02660364",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.