NPIMap

Individual provider Active NPI

Alex Jenny Ky-Miyasaka, MD

  • Surgery Physician
  • New York, NY
National Provider Identifier
1154398568
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
203197 Issued in NY
Practice address
5 East 98TH Street
14TH FL
New York, NY 10029-6574
Phone
(212) 241-1303
Fax
(212) 534-2654
NPI assigned
Mar 3, 2006
Last updated
Nov 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 203197 NY Primary
Colon & Rectal Surgery Physician 208C00000X 203197 NY

Addresses

Primary practice location

5 East 98TH Street
14TH FL
New York, NY 10029-6574

Mailing address

Box 1263
1 Gustave L Levy PL
New York, NY 10029-6574
Phone (212) 241-1303

Other identifiers 1

IdentifierTypeStateIssuer
02081854MedicaidNY

Other names 1

  • Dr. Alex J Ky Professional name

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
I20070615000046 NY Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 2860591856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
State University of New York at Stony Brook, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13516 Roosevelt Ave
Flushing, NY 11354-5365
Phone (718) 559-0312

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy46
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203197NYMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yorkville Endoscopy, LLC CurrentSince Sep 13, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Surgery Current Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Mount Sinai Hospital Past Accepting new patients

Locations

13620 38th Ave
Flushing, NY 11354
Phone (718) 353-7701

150 E 42nd St
New York, NY 10017
Phone (212) 661-8139

201 E 93rd St
New York, NY 10128
Phone (917) 281-0100

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

5 E 98th St
Fl 14
New York, NY 10029
Phone (212) 241-7646

Networks

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

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1154398568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 1263",
            "address_2": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-241-1303",
            "fax_number": "212-534-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 EAST 98TH STREET",
            "address_2": "14TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-241-1303",
            "fax_number": "212-534-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KY-MIYASAKA",
        "first_name": "ALEX",
        "middle_name": "JENNY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "203197",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NY",
            "license": "203197",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02081854",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEX",
            "last_name": "KY",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.