Organization Active NPI

Igor Kusayev Medical P.C.

  • Anesthesiology Physician
  • Manhasset, NY
National Provider Identifier
1194979740
Registry record updated Nov 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
220339 Issued in NY
Legal business name
IGOR KUSAYEV MEDICAL P.C.
Practice address
1129 Northern Blvd
Manhasset, NY 11030-3022
Phone
(347) 247-6773
NPI assigned
Nov 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2008

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

Authorized official

Name
Dr. Igor Kusayev, M.D.NPI 1033150826
Title
Authorized Representative
Phone
(347) 247-6773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X 220339 NY Primary

Addresses

Primary practice location

1129 Northern Blvd
Manhasset, NY 11030-3022

Mailing address

11902 83Rd Ave
Kew Gardens, NY 11415-1322
Phone (347) 247-6773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000020 NY Part B Supplier - Clinic/Group Practice 8729137518 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY; Rego Park, NY; New Hyde Park, NY; Maspeth, NY; Jamaica, NY; Great Neck, NY; Forest Hills, NY

National Provider Directory

National Provider Directory

Locations

488 Great Neck Rd
#201
Great Neck, NY 11021
Phone (516) 482-6747

1129 Northern Blvd
#409
Manhasset, NY 11030
Phone (515) 365-7475

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226275200000",
    "number": "1194979740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11902 83RD AVE",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151322",
            "telephone_number": "347-247-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 NORTHERN BLVD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303022",
            "telephone_number": "347-247-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGOR KUSAYEV MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-10",
        "last_updated": "2008-11-10",
        "status": "A",
        "authorized_official_last_name": "KUSAYEV",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "347-247-6773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "220339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.