NPIMap

Individual provider Active NPI

Viktoriya Mirkin, PA-C

  • Vascular Surgery Physician
  • New York, NY
National Provider Identifier
1053719187
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
018222 Issued in NY
Practice address
525 E 68TH St
New York, NY 10065-4870
Phone
(646) 525-1188
NPI assigned
Dec 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 018222 NY
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 018222 NY Primary

Addresses

Primary practice location

525 E 68TH St
New York, NY 10065-4870

Mailing address

525 E 68TH St
New York, NY 10065-4870
Phone (646) 962-8456

Other practice location 1

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 562-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160927002580 NY Practitioner - Physician Assistant 0345537833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

50 E 69TH St
New York, NY 10021-5002
Phone (212) 746-5593

525 E 68TH St
New York, NY 10065-4870
Phone (212) 746-2157

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
018222NYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Single Specialty CurrentSince May 1, 2020 Accepting new patients
Weill Medical College of Cornell Single Specialty CurrentSince May 1, 2020 Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

50 E 69th St
New York, NY 10021
Phone (212) 570-4000

525 E 68th St
#8
New York, NY 10065
Phone (646) 962-8450

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: vim9094@direct.nyp.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1053719187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "646-962-8456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "646-525-1188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Port Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Roslyn",
            "state": "NY",
            "postal_code": "115761347",
            "country_code": "US",
            "telephone_number": "516-562-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRKIN",
        "first_name": "VIKTORIYA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-05",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "018222",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "018222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.