Active NPI
Moshe Ovaidov, PA
- Physician Assistant
- Rego Park, NY
National Provider Identifier
1053641472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 013810
- Practice address
- 6360 98TH St Apt E7
Rego Park, NY 11374-2226 - Phone
- (646) 595-7171
- NPI assigned
- Jan 7, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 013810 | NY | |
| Physician Assistant | 363A00000X | 013810 | NY | Primary |
Addresses
Primary practice location
6360 98TH St Apt E7
Rego Park, NY 11374-2226
Mailing address
6360 98TH St Apt E7
Rego Park, NY 11374-2226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013810 | NY | MD | General Acute Care Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486771200000",
"number": "1053641472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6360 98TH ST APT E7",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6360 98TH ST APT E7",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742226",
"telephone_number": "646-595-7171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVAIDOV",
"first_name": "MOSHE",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-07",
"last_updated": "2017-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "NY",
"license": "013810",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "013810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.