Individual provider Active NPI

Moriah Sirotkin, NP

  • Pediatric Nurse Practitioner
  • New York, NY
National Provider Identifier
1083246391
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F383017-01 Issued in NY
Practice address
1150 Saint Nicholas Ave
New York, NY 10032-3822
Phone
(212) 851-5494
NPI assigned
Feb 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F383017-01 NY Primary

Addresses

Primary practice location

1150 Saint Nicholas Ave
New York, NY 10032-3822

Mailing address

949 48TH St
Brooklyn, NY 11219-2919

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F383017-01NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Apr 8, 2022 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Apr 8, 2022 Accepting new patients
MMC Pediatrics Faculty Practice CurrentSince Sep 7, 2020 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Sep 7, 2020 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients

Locations

4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

1150 Saint Nicholas Ave
New York, NY 10032
Phone (212) 304-5494

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1083246391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 48TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 SAINT NICHOLAS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323822",
            "telephone_number": "212-851-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIROTKIN",
        "first_name": "MORIAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383017-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.