Individual provider Active NPI

Olga Matsibekker, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1952403156
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
199992 Issued in NY
Practice address
1250 57TH Street
Brooklyn, NY 11219
Phone
(718) 283-5700
Fax
(718) 283-5730
NPI assigned
Sep 1, 2006
Last updated
Jul 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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 199992 NY Primary

Addresses

Primary practice location

1250 57TH Street
Brooklyn, NY 11219

Mailing address

1250 57TH Street
Brooklyn, NY 11219
Phone (718) 283-5700

Other identifiers 1

IdentifierTypeStateIssuer
01603447MedicaidNY

Other names 1

  • Mrs. Olga Matsibekker Professional name

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
I20101116000998 NY Practitioner - Internal Medicine 0345435327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maimonides Faculty Practice PlanGroup PAC ID 7012808348, 251 clinicians

Practice addresses (Care Compare)

1250 57TH St
Brooklyn, NY 11219-4537
Phone (718) 283-8773

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
199992NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Faculty Practice Plan Internal Medicine CurrentSince Jul 1, 2000 Accepting new patients
Maimonides Medical Center Current Accepting new patients

Locations

1250 57th St
Brooklyn, NY 11219
Phone (718) 283-5700

4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018

4702 Fort Hamilton Pkwy
#P
Brooklyn, NY 11219

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Networks

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

Interoperability endpoints

  • Direct secure messaging: olga.matsibekker.p1@direct.mmc.nextgenshare.com
  • Direct secure messaging: olgamatsibekker@mai.allscriptsdirect.net

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

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1952403156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 57TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-283-5700",
            "fax_number": "718-283-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 57TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-283-5700",
            "fax_number": "718-283-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSIBEKKER",
        "first_name": "OLGA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "199992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01603447",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLGA",
            "last_name": "MATSIBEKKER",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.