Individual provider Active NPI

Igor Zhuravenko, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1962438598
Registry record updated Nov 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
210937 Issued in NY
Practice address
3048 Brighton 1St St # 6B
Brooklyn, NY 11235-8080
Phone
(718) 945-4545
Fax
(347) 702-9545
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2020

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 210937 NY Primary

Addresses

Primary practice location

3048 Brighton 1St St # 6B
Brooklyn, NY 11235-8080

Mailing address

197 Beach 137 Street
Rockaway Park, NY 11694
Phone (718) 375-1777

Other practice location 1

197 Beach 137th St
Rockaway Park, NY 11694-1329
Phone (718) 375-1777

Other identifiers 1

IdentifierTypeStateIssuer
01879116MedicaidNY

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
I20040319000966 NY Practitioner - Internal Medicine 5294649828

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

197 Beach 137TH St
Rockaway Park, NY 11694-1329

Hospital & facility affiliations

  • Girling Health Care of New York Home health agency, Brooklyn, NY, CCN 337243

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Group Medical Associates, P.C Internal Medicine Past Accepting new patients

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.

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604707200000",
    "number": "1962438598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 BEACH 137 STREET",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "11694",
            "telephone_number": "718-375-1777",
            "fax_number": "718-382-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 BRIGHTON 1ST ST # 6B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358080",
            "telephone_number": "718-945-4545",
            "fax_number": "347-702-9545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "197 Beach 137th St",
            "address_purpose": "LOCATION",
            "city": "Rockaway Park",
            "state": "NY",
            "postal_code": "116941329",
            "country_code": "US",
            "telephone_number": "718-375-1777",
            "fax_number": "718-382-1777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHURAVENKO",
        "first_name": "IGOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-11-07",
        "certification_date": "2020-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "210937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01879116",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.