Individual provider Active NPI

Marina Gafanovich, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1942328802
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
236435 Issued in NY
Practice address
1550 York Ave
New York, NY 10028-5970
Phone
(212) 249-6218
Fax
(212) 628-7059
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 236435 NY Primary

Addresses

Primary practice location

1550 York Ave
New York, NY 10028-5970

Mailing address

1550 York Ave
New York, NY 10028-5970
Phone (212) 249-6218

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
I20060113000909 NY Practitioner - Internal Medicine 4284658402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1550 York Ave
New York, NY 10028-5970
Phone (212) 249-6219

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marina Gafanovich MD PC Internal Medicine CurrentSince Feb 1, 2008 Accepting new patients

Locations

1550 York Ave
New York, NY 10028
Phone (212) 249-6218

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1942328802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100285970",
            "telephone_number": "212-249-6218",
            "fax_number": "212-628-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100285970",
            "telephone_number": "212-249-6218",
            "fax_number": "212-628-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAFANOVICH",
        "first_name": "MARINA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "236435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.