Kaiduan Pi, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

226099 Issued in NY

Practice address

100 Port Washington Blvd
Roslyn, NY 11576-1353

Phone

(516) 242-0424

Fax

(615) 674-7079

NPI assigned

Jan 11, 2007

Last updated

May 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Momentum Medical Services, PC.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Brooklyn, NY
  • NPI 1205279031
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1063562957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1529",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110507529",
            "telephone_number": "516-242-0424",
            "fax_number": "516-674-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761353",
            "telephone_number": "516-242-0424",
            "fax_number": "615-674-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PI",
        "first_name": "KAIDUAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "226099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02337997",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Marius Pessah
• George A. Petrossian, M.D.
• Asha Phillips
• Lisa S. Phillips, M.D.
• Physicians Diagnostic Imaging, PC
• Marie Piacentini, SLP
• Frances Pierre, RN
• Alan Pine, M.S., LMHC, CGP
• Juliet Posner-Earls, OTR
• Mitchell Lloyd Powell

• Surgery Physician in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.