Individual provider Active NPI

Victoria Golovatenko

  • Surgical Physician Assistant
  • Bronx, NY
National Provider Identifier
1922438142
Registry record updated Nov 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
017236 Issued in NY
Practice address
234 E 149TH St
Bronx, NY 10451-5504
Phone
(718) 579-5900
NPI assigned
Nov 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 017236 NY Primary

Addresses

Primary practice location

234 E 149TH St
Bronx, NY 10451-5504

Mailing address

1502 W 5TH St Apt 2C
Brooklyn, NY 11204-4919
Phone (917) 774-2948

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140801001324 NY Practitioner - Physician Assistant 8628294386 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York Downstate Medical Center, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

234 E 149 St
Bronx, NY 10451-5504
Phone (718) 579-6101

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

Hospital & facility affiliations

  • Lincoln Medical & Mental Health Center Hospital, Bronx, NY, CCN 330080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Nov 22, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Nov 22, 2016 Accepting new patients
Jamaica Hospital CurrentSince Jul 1, 2021 Accepting new patients
Jamaica Hospital CurrentSince Jul 1, 2021 Accepting new patients
Lincon Medical and Mental Center Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Interoperability endpoints

  • Direct secure messaging: vgolovatenko676056@nychhc.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1922438142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 W 5TH ST APT 2C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044919",
            "telephone_number": "917-774-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOVATENKO",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "017236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.