Individual provider Active NPI

Marina Novikova, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1952349318
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
225719 Issued in NY
Practice address
1110 Pennsylvania Ave
Brooklyn, NY 11207-9061
Phone
(718) 649-5519
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 225719 NY Primary

Addresses

Primary practice location

1110 Pennsylvania Ave
Brooklyn, NY 11207-9061

Mailing address

2225 E 69TH St
Brooklyn, NY 11234-6521
Phone (718) 909-2994

Other identifiers 1

IdentifierTypeStateIssuer
02364189MedicaidNY

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
I20071019000326 NY Practitioner - Pediatric Medicine 7517068190 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Interfaith Professional Physician Services, P.C. Pediatrics CurrentSince Jul 12, 2024 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Feb 1, 2013 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Feb 1, 2013 Accepting new patients
Brookdale Family Care Center, Inc. Pediatrics Past Accepting new patients

Locations

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1873 Eastern Pkwy
Brooklyn, NY 11233
Phone (718) 240-5133

465 New Lots Ave
Brooklyn, NY 11207
Phone (718) 240-5133

2554 Linden Blvd
Brooklyn, NY 11208
Phone (718) 240-5132

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

Networks

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

Organizations & group practices 4

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952349318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 E 69TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346521",
            "telephone_number": "718-909-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112079061",
            "telephone_number": "718-649-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVIKOVA",
        "first_name": "MARINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "225719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02364189",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.