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BORIS BAKANOV NP
NPI 1811763576
Nurse Practitioner - Adult Health in New York, NY

Active since December 04, 2023PECOS Enrolled
440 W 114TH ST FL 6, NEW YORK, NY 10025(212) 523-8570 Get Directions Write a Review

NPPES record last updated: January 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Boris Bakanov Np NPPES

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

BORIS BAKANOV NP (NPI 1811763576) is an individual adult health provider in New York, New York, licensed in New York (F311621) and active in the NPI registry since December 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1811763576
Entity TypeIndividualMale
Primary Taxonomy363LA2200X
Provider Legal NameBORIS BAKANOVCredential: NP
Location Address440 W 114TH ST FL 6New York, NY 10025-1796
Mailing Address1660 E 66th StBrooklyn, NY 11234 · (718) 404-8156
Phone(212) 523-8570
Sole ProprietorNo
Enumeration DateDecember 4, 2023
Last NPPES UpdateJanuary 23, 2025
NPPES CertifiedJanuary 23, 2025
✔ NPI 1811763576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in NY · F311621
440 W 114TH ST FL 6, New York, NY 10025
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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 (PECOS)

Boris Bakanov Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10025 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
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAMIAN PHILLIP REID NP
Nurse Practitioner (Adult Health)
440 W 114TH ST FL 6
NEW YORK, NY 10025
New York County (212) 523-8570
SHAUN HUI RD, CDN, CDCES
Dietitian, Registered
440 W 114TH ST FL 6
NEW YORK, NY 10025
New York County (212) 523-6500
DR. TIMOTHY STAHL PH.D.
Psychologist (Clinical)
440 W 114TH ST FL 6
NEW YORK, NY 10025
New York County (212) 523-6500

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 Boris Bakanov's NPI number?

The NPI number for Boris Bakanov is 1811763576. It was assigned to this individual provider in the NPPES registry on December 4, 2023.

Where is Boris Bakanov located?

Boris Bakanov practices at 440 W 114th St Fl 6, New York, NY 10025. The listed phone number is (212) 523-8570.

What is Boris Bakanov's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Boris Bakanov enrolled in Medicare?

Yes. Boris Bakanov is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Boris Bakanov was last updated on January 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.