Individual provider Active NPI

Vladimir Moliver, M.D.,D.O.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1942226485
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
210590 Issued in NY
Practice address
4446 Broadway
New York, NY 10040-2939
Phone
(212) 567-6000
Fax
(212) 567-7717
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 210590 NY Primary

Addresses

Primary practice location

4446 Broadway
New York, NY 10040-2939

Mailing address

739 W 186TH St Apt 2H
New York, NY 10033-8520
Phone (212) 567-6000

Other identifiers 4

IdentifierTypeStateIssuer
2188529OtherAETNA PROVIDER #
P1834354OtherOXFORD PROVIDER #
01952661MedicaidNY
5998925OtherGHI PROVIDER #

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
I20081205000491 NY Practitioner - Family Practice 0840351011 Reassigns benefits to 1 organization
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Fort Washington Ave
Apt 1a
New York, NY 10033-6837
Phone (212) 795-9500

Hospital & facility affiliations

  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210590NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Double Care Medical, P.C. CurrentSince Jun 8, 2009 Accepting new patients
Bronx Family Physical Therapy P.C. PastSince Nov 10, 2009 Accepting new patients

Networks

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

Organizations & group practices 2

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1942226485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 W 186TH ST APT 2H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100338520",
            "telephone_number": "212-567-6000",
            "fax_number": "212-567-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4446 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100402939",
            "telephone_number": "212-567-6000",
            "fax_number": "212-567-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLIVER",
        "first_name": "VLADIMIR",
        "name_prefix": "Dr.",
        "credential": "M.D.,D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "210590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "2188529",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER #",
            "identifier": "P1834354",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01952661",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PROVIDER #",
            "identifier": "5998925",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.