Individual provider Active NPI

Simon Barkagan, MD, PHD

  • Specialist
  • Rego Park, NY
National Provider Identifier
1932127271
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
161539 Issued in NY
Practice address
6536 99TH Street
Rego Park, NY 11374-4358
Phone
(718) 830-3611
Fax
(718) 830-0776
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 161539 NY Primary
Urology Physician 208800000X 161539 NY
Surgery Physician 208600000X 161539 NY

Addresses

Primary practice location

6536 99TH Street
Rego Park, NY 11374-4358

Mailing address

6536 99TH St
Rego Park, NY 11374-4358
Phone (718) 830-3611

Other identifiers 2

IdentifierTypeStateIssuer
00954792MedicaidNY
62886OtherNYGHI MEDICARE PIN

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
I20071108000053 NY Practitioner - Urology 7618064692 Reassigns benefits to 1 organization
Practice locations: Rego Park, NY; Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mihail Medvedovsky Physician PCGroup PAC ID 3779474937, 12 clinicians

Practice addresses (Care Compare)

3039 Ocean Pkwy
Brooklyn, NY 11235-8378
Phone (718) 946-9070

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
161539NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mihail Medvedovsky Physician PC CurrentSince Jan 1, 2023 Accepting new patients

Locations

3039 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 946-9070

Networks

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

Organizations & group practices 1

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 6

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1932127271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6536 99TH ST",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744358",
            "telephone_number": "718-830-3611",
            "fax_number": "718-830-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6536 99TH STREET",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744358",
            "telephone_number": "718-830-3611",
            "fax_number": "718-830-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKAGAN",
        "first_name": "SIMON",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "161539",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "161539",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "161539",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00954792",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE PIN",
            "identifier": "62886",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.