Individual provider Active NPI

Dina Perepelyuk, R-PAC

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1952513574
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
006013-1 Issued in NY
Practice address
2165 71St St
Brooklyn, NY 11204-5526
Phone
(718) 621-7100
NPI assigned
May 4, 2007
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
Medical Physician Assistant 363AM0700X 006013-1 NY Primary

Addresses

Primary practice location

2165 71St St
Brooklyn, NY 11204-5526

Mailing address

2165 71St St
Brooklyn, NY 11204-5526
Phone (718) 621-7100

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090601000317 NY Practitioner - Physician Assistant 7416006051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chinatown True Care Medical PLLCGroup PAC ID 2163859760, 245 clinicians

Practice addresses (Care Compare)

355 Ovington Ave
Suite 202
Brooklyn, NY 11209-1458
Phone (718) 621-7100

8686 Bay Pkwy
Suite M1
Brooklyn, NY 11214-5193
Phone (718) 372-0888

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006013-1NYMDMedical Physician Assistant

Networks

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

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952513574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 71ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045526",
            "telephone_number": "718-621-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 71ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045526",
            "telephone_number": "718-621-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREPELYUK",
        "first_name": "DINA",
        "credential": "R-PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006013-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.