1. Home
  2. Directory
  3. New York
  4. Mineola
  5. Internal Medicine
  6. NPI Profile

QUEENS NASSAU NEPHROLOGY SERVICES PLLC
NPI 1992934467
Internal Medicine - Nephrology in Mineola, NY

Active since July 06, 2009
300 OLD COUNTRY ROAD, 111, MINEOLA, NY 11501(516) 745-0500(516) 745-1534 Get Directions Write a Review

NPPES record last updated: December 5, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Queens Nassau Nephrology Services Pllc NPPES

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

QUEENS NASSAU NEPHROLOGY SERVICES PLLC (NPI 1992934467) is a healthcare organization registered as a nephrology in Mineola, New York and active in the NPI registry since July 2009. The organization lists Andrey Goncharuk, President, as its authorized official.

NPPES Registry Identity

NPI1992934467
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameQUEENS NASSAU NEPHROLOGY SERVICES PLLC
Location Address300 OLD COUNTRY ROAD, 111Mineola, NY 11501-4112
Mailing Address300 Old Country Road, 111Mineola, NY 11501-4112 · (516) 745-0500 · Fax (516) 745-1534
Phone(516) 745-0500
Fax(516) 745-1534
Organization SubpartNo
Authorized OfficialAndrey GoncharukPresident · (516) 745-0500
Enumeration DateJuly 6, 2009
Last NPPES UpdateDecember 5, 2014
✔ NPI 1992934467 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in NY · 199896
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedInternal MedicineTaxonomy 207R00000X
300 OLD COUNTRY ROAD, Mineola, NY 11501
Open in Google Maps ↗

Other Identifiers 4

Medicare PINA100023879
Medicare PINA100023879NY
Medicaid03340883NY
Medicare PING100121495

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Queens Nassau Nephrology Services Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Queens Nassau Nephrology Services PLLC, which bills Medicare for the services they deliver. Of these, 7 practice at this address. They are listed nearest first.

Clinicians, nearest first (7)

Vincent Avila, M.D.
Nephrology
NPI 1518965110
300 OLD COUNTRY RD SUITE 111
Mineola, NY 11501
(516) 745-0500
✔ PECOS✔ Accepts MedicareSame address
Eduard Bover, D.O.
Nephrology
NPI 1801831763
300 OLD COUNTRY RD SUITE 111
Mineola, NY 11501
(516) 745-0500
✔ PECOS✔ Accepts MedicareSame address
Christopher Caputo, M.D.
Nephrology
NPI 1992703490
300 OLD COUNTRY RD SUITE 111
Mineola, NY 11501
(516) 745-0500
✔ PECOS✔ Accepts MedicareSame address
Andrey Goncharuk, M.D.
Nephrology
NPI 1356349922
300 OLD COUNTRY RD SUITE 111
Mineola, NY 11501
(516) 745-0500
✔ PECOSSame address
Binny Koshy, M.D.
Nephrology
NPI 1114925708
300 OLD COUNTRY RD SUITE 111
Mineola, NY 11501
(516) 745-0500
✔ PECOS✔ Accepts MedicareSame address
Mario Marotta, M.D.
Nephrology
NPI 1871591453
300 OLD COUNTRY RD SUITE 111
Mineola, NY 11501
(516) 745-0500
✔ PECOS✔ Accepts MedicareSame address
Yelena Rosenberg, M.D.
Nephrology
NPI 1598763187
300 OLD COUNTRY RD SUITE 111
Mineola, NY 11501
(516) 745-0500
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Queens Nassau Nephrology Services PLLC's NPI number?

The NPI number for Queens Nassau Nephrology Services PLLC is 1992934467. It was assigned to this organization in the NPPES registry on July 6, 2009.

Where is Queens Nassau Nephrology Services PLLC located?

Queens Nassau Nephrology Services PLLC is located at 300 Old Country Road 111, Mineola, NY 11501. The listed phone number is (516) 745-0500.

What is Queens Nassau Nephrology Services PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Queens Nassau Nephrology Services PLLC enrolled in Medicare?

Yes. Queens Nassau Nephrology Services PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Queens Nassau Nephrology Services PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians, all in Nephrology, reassign their Medicare billing to Queens Nassau Nephrology Services PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 7 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Queens Nassau Nephrology Services PLLC was last updated on December 5, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.