Individual provider Active NPI

Natalya Gazizov, MD

  • Internal Medicine Physician
  • Merrick, NY
National Provider Identifier
1144587106
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD446222 Issued in PA
Practice address
47 Montauk Ave
Merrick, NY 11566-4594
Phone
(516) 513-0626
NPI assigned
Apr 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD446222 PA Primary

Addresses

Primary practice location

47 Montauk Ave
Merrick, NY 11566-4594

Mailing address

47 Montauk Ave
Merrick, NY 11566-4594
Phone (516) 513-0626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20121221000005 PA Practitioner - Internal Medicine 1052563012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pennsylvania HM Associates, PCGroup PAC ID 0547404337, 31 clinicians

Practice addresses (Care Compare)

206 E Brown St
Pocono Medical Center
East Stroudsburg, PA 18301-3094
Phone (570) 421-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD446222PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania HM Associates PC CurrentSince Aug 1, 2013 Accepting new patients
Lehigh Valley Hospital Pocono Past Accepting new patients
The Brookdale Hospital Medical Center Past Accepting new patients

Locations

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

Organizations & group practices 3

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 9

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": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1144587106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 MONTAUK AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664594",
            "telephone_number": "516-513-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 MONTAUK AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664594",
            "telephone_number": "516-513-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZIZOV",
        "first_name": "NATALYA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD446222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

Verify at the official NPI Registry.