Individual provider Active NPI

Maryana Kotynkevych

  • Podiatrist
  • Scarsdale, NY
National Provider Identifier
1962964445
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N007314 Issued in NY
Practice address
341 Central Park Ave
Scarsdale, NY 10583-1301
Phone
(914) 370-5000
NPI assigned
Apr 3, 2019
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Podiatrist 213E00000X N007314 NY Primary

Addresses

Primary practice location

341 Central Park Ave
Scarsdale, NY 10583-1301

Mailing address

317 E 17TH St Fierman Hall 12
New York, NY 10003-3804

Other practice location 1

317 E 17th St Fierman Hall 12
New York, NY 10003-3804
Phone (347) 322-0998

Other practice location 2

116 Fifth Ave
Pelham, NY 10803-1504
Phone (914) 813-3133

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231006001100 NY Practitioner - Podiatry 1153652995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

341 Central Park Ave
Scarsdale, NY 10583-1301
Phone (914) 779-2995

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue17
Removal of nail tissue171
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007314NYMDAcupuncturist
N007314NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine of New York University Current Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Sep 7, 2025 Accepting new patients
Mount Sinai School of Medicine of New York University CurrentSince Nov 1, 2023 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Sep 7, 2025 Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

116 Fifth Ave
Pelham, NY 10803
Phone (914) 738-0005

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

341 Central Park Ave
Scarsdale, NY 10583
Phone (718) 676-5309

1010 N Broadway
Yonkers, NY 10701
Phone (914) 968-3535

Networks

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

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1962964445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 E 17TH ST FIERMAN HALL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 CENTRAL PARK AVE",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831301",
            "telephone_number": "914-370-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 E 17th St Fierman Hall 12",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100033804",
            "country_code": "US",
            "telephone_number": "347-322-0998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "116 Fifth Ave",
            "address_purpose": "LOCATION",
            "city": "Pelham",
            "state": "NY",
            "postal_code": "108031504",
            "country_code": "US",
            "telephone_number": "914-813-3133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTYNKEVYCH",
        "first_name": "MARYANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N007314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

Verify at the official NPI Registry.