Individual provider Active NPI

Alla B Buzinover, DO

  • Adult Medicine Physician
  • New York, NY
National Provider Identifier
1962684159
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
255180 Issued in NY
Practice address
4290 Broadway Ste 2S
New York, NY 10033-3732
Phone
(212) 781-5100
Fax
(212) 781-5329
NPI assigned
Nov 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 255180 NY Primary

Addresses

Primary practice location

4290 Broadway Ste 2S
New York, NY 10033-3732

Mailing address

4290 Broadway Ste 2S
New York, NY 10033-3732
Phone (212) 781-5100

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
I20110810000491 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 9133398035 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peninsula Medical Care PLLCGroup PAC ID 5698934446, 8 clinicians
Allcity Medical PCGroup PAC ID 7012144462, 5 clinicians
Brooklyn Comprehensive Care Center Inc.Group PAC ID 9830148279, 14 clinicians

Practice addresses (Care Compare)

11506 Beach Channel Dr
Suite 101
Rockaway Park, NY 11694-2113
Phone (718) 474-7744

2814 Clarendon Rd
Brooklyn, NY 11226-6318
Phone (718) 469-7363

7608 Bay Pkwy
Brooklyn, NY 11214-1572
Phone (718) 333-2500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255180NYMDAdult Medicine Physician

Practice roles (3 of 7)

OrganizationSpecialtyStatusNew patients
Brooklyn Comprehensive Care Center Inc. CurrentSince Nov 2, 2021 Accepting new patients
Allcity Medical, P.C. CurrentSince Jan 1, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2814 Clarendon Rd
Brooklyn, NY 11226
Phone (718) 469-7363

343 W 145th St
New York, NY 10031
Phone (212) 444-8877

4290 Broadway
Ste 2S
New York, NY 10033
Phone (212) 781-5075

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • 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": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1962684159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 BROADWAY STE 2S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333732",
            "telephone_number": "212-781-5100",
            "fax_number": "212-781-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 BROADWAY STE 2S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333732",
            "telephone_number": "212-781-5100",
            "fax_number": "212-781-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUZINOVER",
        "first_name": "ALLA",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NY",
            "license": "255180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.