Individual provider Active NPI

Olga Guskova, PA-C

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1942680517
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018621 Issued in NY
Practice address
329 Olympia Blvd
Unit a
Staten Island, NY 10305-4233
Phone
(347) 782-8207
NPI assigned
Jun 8, 2015
Last updated
Jun 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 018621 NY Primary

Addresses

Primary practice location

329 Olympia Blvd
Unit a
Staten Island, NY 10305-4233

Mailing address

329 Olympia Blvd
Unit a
Staten Island, NY 10305-4233
Phone (347) 782-8207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230124002274 FL Practitioner - Physician Assistant 2961717202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Medicine Specialists, IncGroup PAC ID 1658335328, 60 clinicians

Practice addresses (Care Compare)

3599 Univeristy Blvd S
Jacksonville, FL 32216-4252
Phone (904) 345-7600

3901 University Blvd S
Jacksonville, FL 32216-4312
Phone (904) 345-7373

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
99
Improvement activities
40
Cost
85.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018621NYMDPhysical Therapist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1942680517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 OLYMPIA BLVD",
            "address_2": "UNIT A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054233",
            "telephone_number": "347-782-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 OLYMPIA BLVD",
            "address_2": "UNIT A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054233",
            "telephone_number": "347-782-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSKOVA",
        "first_name": "OLGA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.