Organization Active NPI

Irina Kovaleva Medical Care PC

  • Physical Medicine & Rehabilitation Physician
  • Brooklyn, NY
National Provider Identifier
1922423771
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
223507 Issued in NY
Legal business name
IRINA KOVALEVA MEDICAL CARE PC
Practice address
2952 Brighton 3Rd St
Suite 301
Brooklyn, NY 11235-6897
Phone
(718) 708-4046
Fax
(718) 732-2728
NPI assigned
Mar 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Irina KovalevaNPI 1972537991
Title
MD
Phone
(718) 333-1025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 223507 NY Primary

Addresses

Primary practice location

2952 Brighton 3Rd St
Suite 301
Brooklyn, NY 11235-6897

Mailing address

2952 Brighton 3Rd St
Suite 301
Brooklyn, NY 11235-6897
Phone (718) 708-4046

Other identifiers 2

IdentifierTypeStateIssuer
02349948MedicaidNY
03836308MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150309000874 NY Part B Supplier - Clinic/Group Practice 3779809868 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

2952 Brighton 3rd St
Ste 301
Brooklyn, NY 11235
Phone (718) 232-4100

3121 Ocean Ave
Ste 503
Brooklyn, NY 11235
Phone (718) 708-4046

3121 Ocean Ave
#503
Brooklyn, NY 11235

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1922423771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2952 BRIGHTON 3RD ST",
            "address_2": "SUITE 301",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356897",
            "telephone_number": "718-708-4046",
            "fax_number": "718-732-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2952 BRIGHTON 3RD ST",
            "address_2": "SUITE 301",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356897",
            "telephone_number": "718-708-4046",
            "fax_number": "718-732-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRINA KOVALEVA MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-03",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "KOVALEVA",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "718-333-1025"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "223507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02349948",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03836308",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.