Mikhail Tismenetsky, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

25MA08289600 Issued in NJ

Practice address

350 Engle St
Englewood, NJ 07631-1808

Phone

(201) 894-1702

Fax

(201) 871-2269

NPI assigned

Aug 22, 2007

Last updated

Aug 22, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in NJ

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

Specialty

Pathology

Education

Wayne State University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Englewood Pathologists, PAGroup PAC ID 3779671672, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Merit-based Incentive Payment System (MIPS)

Final score

86.67 of 100Reported as group

Quality

73.33

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Englewood Pathologists, PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Englewood, NJ
  • NPI 1053366054
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Englewood Hospital and Medical Center

  • General Acute Care Hospital
  • Englewood, NJ
  • NPI 1083612881
  Care Compare affiliation

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1205029212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8069",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076318069",
            "telephone_number": "201-894-1702",
            "fax_number": "201-871-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "201-894-1702",
            "fax_number": "201-871-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISMENETSKY",
        "first_name": "MIKHAIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA08289600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thoracic and Vascular Associates of New Jersey
• Elizabeth Thottumalil Thomas
• Joan D. Timbang, PT
• Bruce Tisch, MD
• Danielle Tischer
• Priscilla Tixi
• Aileen P. Tlamsa, M.D.
• Tmscoa, LLC (TMS Centers of America)
• Geoffrey Wayne Tobias, MO
• Jose Tobon-Marin

• Anatomic Pathology & Clinical Pathology Physician in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Anatomic Pathology & Clinical Pathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.