LARISSA FOMITCHEVA M.D.
NPI 1780695718
Obstetrics & Gynecology in Lindenhurst, NY

Q: What is Larissa Fomitcheva's NPI number?

The NPI number for Larissa Fomitcheva is 1780695718. It was assigned to this individual provider in the NPPES registry on August 11, 2006.

Q: What is Larissa Fomitcheva's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Active since August 11, 2006PECOS EnrolledAccepts Medicare Assignment

57 W SUNRISE HWY, LINDENHURST, NY 11757(631) 466-5242(866) 468-0236 Get Directions Write a Review

NPPES record last updated: August 30, 2024. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Larissa Fomitcheva M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LARISSA FOMITCHEVA M.D. (NPI 1780695718) is an individual obstetrics & gynecology provider in Lindenhurst, New York, licensed in New York (241373) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Good Samaritan Hospital Medical Center, and is a graduate of Other (1990).

NPPES Registry Identity

NPI1780695718

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameLARISSA FOMITCHEVACredential: M.D.

Location Address57 W SUNRISE HWYLindenhurst, NY 11757-2426

Mailing Address57 W Sunrise HwyLindenhurst, NY 11757-2426 · (347) 523-0054

Phone(631) 466-5242

Fax(866) 468-0236

Sole ProprietorNo

Medical School CMSOtherGraduated 1990

Enumeration DateAugust 11, 2006

Last NPPES UpdateAugust 30, 2024

NPPES CertifiedAugust 30, 2024

✔ NPI 1780695718 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in NY · 241373

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

57 W SUNRISE HWY, Lindenhurst, NY 11757

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Larissa Fomitcheva M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416028444

PECOS Enrollment IDI20150518000756

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Good Samaritan Hospital Medical Center

Acute Care Hospitals · West Islip, NY

1/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number330286

Location1000 Montauk HighwayWest Islip, NY 11795 · Suffolk County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11757 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$154.28 typical visit price

range $67.40 – $203.53

Typical copayment $38.57 (range $16.85 – $50.88)

Most-billed visit code 99204

Established Patient

$83.44 typical visit price

range $21.66 – $164.45

Typical copayment $20.86 (range $5.41 – $41.11)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Larissa Fomitcheva's NPI number?

The NPI number for Larissa Fomitcheva is 1780695718. It was assigned to this individual provider in the NPPES registry on August 11, 2006.

Where is Larissa Fomitcheva located?

Larissa Fomitcheva practices at 57 W Sunrise Hwy, Lindenhurst, NY 11757. The listed phone number is (631) 466-5242.

What is Larissa Fomitcheva's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Larissa Fomitcheva enrolled in Medicare?

Yes. Larissa Fomitcheva is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Larissa Fomitcheva affiliated with any hospitals?

According to CMS data, Larissa Fomitcheva is affiliated with Good Samaritan Hospital Medical Center.

When was this NPI record last updated?

The NPPES record for Larissa Fomitcheva was last updated on August 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.