Andrey Moiseyenko, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

240 Meeting House Lane
Stony Brook Southampton Hospital Intern Medicine
Southampton, NY 11968

Phone

(631) 726-0409

NPI assigned

May 4, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1154066074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LANE",
            "address_2": "STONY BROOK SOUTHAMPTON HOSPITAL INTERN MEDICINE",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LANE",
            "address_2": "STONY BROOK SOUTHAMPTON HOSPITAL INTERN MEDICINE",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968",
            "telephone_number": "631-726-0409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Heroes Way",
            "address_2": "Peconic Bay Medical Center Graduate Medical education",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "11901",
            "country_code": "US",
            "telephone_number": "631-548-6446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOISEYENKO",
        "first_name": "ANDREY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-04",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abhinav Mishra, MD
• Rokshana Mishu
• Matthew Paul Mobius I, MS,PT,OCS
• Sony Ann Modayil, DO
• Areej Moghni, DO
• Forough B Mokhtari, MD
• James Arthur Moore, M.D.
• Suzanne Leslie Moore, RNFA
• Teiah Moore, D.O.
• Angela Maria Morales

• Student in an Organized Health Care Education/Training Program in Southampton, NY
• Providers in Southampton, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.