Individual provider Active NPI

Marina Podval, MD

  • Internal Medicine Physician
  • Flushing, NY
National Provider Identifier
1982717237
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
214459 Issued in NY
Practice address
4332 Kissena Blvd
La
Flushing, NY 11355-2934
Phone
(718) 939-0609
Fax
(718) 939-4509
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2012

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 214459 NY Primary

Addresses

Primary practice location

4332 Kissena Blvd
La
Flushing, NY 11355-2934

Mailing address

4332 Kissena Blvd
La
Flushing, NY 11355-2934
Phone (718) 939-0609

Other identifiers 1

IdentifierTypeStateIssuer
02041798MedicaidNY

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
I20100714000030 NY Practitioner - Internal Medicine 1254463029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

43 -32 Kissena Blvd
Suite la
Flushing, NY 11355-2934
Phone (718) 939-0609

68 Ave O
Ground Floor
Brooklyn, NY 11204-6427
Phone (718) 975-7002

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214459NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marina Podval Medical PC Internal Medicine CurrentSince Feb 21, 2001 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients
Marina Podval PC Internal Medicine Past Accepting new patients

Locations

7206 Bay Pkwy
Brooklyn, NY 11204
Phone (718) 232-9191

Networks

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

Organizations & group practices 3

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 5

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1982717237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4332 KISSENA BLVD",
            "address_2": "LA",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552934",
            "telephone_number": "718-939-0609",
            "fax_number": "718-939-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4332 KISSENA BLVD",
            "address_2": "LA",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552934",
            "telephone_number": "718-939-0609",
            "fax_number": "718-939-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODVAL",
        "first_name": "MARINA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "214459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02041798",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.