Individual provider Active NPI

Anaida Abagyan-Stanczyk, DPM

  • Foot & Ankle Surgery Podiatrist
  • Flushing, NY
National Provider Identifier
1194250274
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
007157 Issued in NY
Practice address
5645 Main St
4TH FL
Flushing, NY 11355-5045
Phone
(718) 670-2712
Fax
(718) 661-7129
NPI assigned
Apr 26, 2017
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X 007157 NY Primary

Addresses

Primary practice location

5645 Main St
4TH FL
Flushing, NY 11355-5045

Mailing address

24 Brentwood Rd
Bay Shore, NY 11706-8011
Phone (631) 666-8100

Other practice location 1

165 Nassau Ave Fl 1
Brooklyn, NY 11222-4023
Phone (718) 389-4404

Other names 1

  • Anaida Abagyan-Stanczyk Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210618000677 NY Practitioner - Podiatry 8224438882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue80
Removal of nail tissue350
Removal or shaving of skin growth86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007157NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Aug 1, 2022 Accepting new patients
Island Wide Medical Care PLLC CurrentSince Jun 11, 2023 Accepting new patients

Locations

5645 Main St
Fl 4
Flushing, NY 11355
Phone (718) 661-7211

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

616 Broadway
Massapequa, NY 11758
Phone (516) 636-5021

Networks

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

Interoperability endpoints

  • Direct secure messaging: anaidaabagyan-stanczyk@nslijmedgr.allscriptsdirect.net

Organizations & group practices 2

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 2

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": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1194250274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 BRENTWOOD RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068011",
            "telephone_number": "631-666-8100",
            "fax_number": "631-665-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "address_2": "4TH FL",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-2712",
            "fax_number": "718-661-7129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 Nassau Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112224023",
            "country_code": "US",
            "telephone_number": "718-389-4404",
            "fax_number": "718-389-5317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABAGYAN-STANCZYK",
        "first_name": "ANAIDA",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-26",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "007157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANAIDA",
            "last_name": "ABAGYAN-STANCZYK",
            "credential": "DPM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.