Individual provider Active NPI

Olga Myszko, M.D.

  • Pediatric Adolescent Medicine Physician
  • New York, NY
National Provider Identifier
1013448455
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
305511 Issued in NY
Practice address
19 Murray St
New York, NY 10007-2240
Phone
(212) 500-6582
Fax
(917) 970-8372
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 305511 NY
Pediatric Adolescent Medicine Physician 2080A0000X 305511 NY Primary

Addresses

Primary practice location

19 Murray St
New York, NY 10007-2240

Mailing address

19 Murray St
New York, NY 10007-2240
Phone (212) 500-6582

Other identifiers 1

IdentifierTypeStateIssuer
305511OtherNYPHYSICIAN LICENSE

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
I20190202000047 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5698012318

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
305511NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1013448455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MURRAY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100072240",
            "telephone_number": "212-500-6582",
            "fax_number": "917-970-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MURRAY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100072240",
            "telephone_number": "212-500-6582",
            "fax_number": "917-970-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSZKO",
        "first_name": "OLGA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "305511",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "305511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "305511",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.