Organization Active NPI

BM Nurse Practitioner in Family Health PC

  • Family Nurse Practitioner
  • Forest Hills, NY
National Provider Identifier
1205393253
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
BM NURSE PRACTITIONER IN FAMILY HEALTH PC
Practice address
6259 108TH St Apt 5H
Forest Hills, NY 11375-1314
Phone
(917) 972-4458
NPI assigned
Feb 26, 2019
Last updated
Feb 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Authorized official

Name
Boris MosheyevNPI 1740726181
Title
FNP
Phone
(917) 972-4458

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
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

6259 108TH St Apt 5H
Forest Hills, NY 11375-1314

Mailing address

6259 108TH St Apt 5H
Forest Hills, NY 11375-1314
Phone (917) 972-4458

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190501000840 NY Part B Supplier - Clinic/Group Practice 4284976879 Receives reassigned benefits from 1 practitioner
Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551139200000",
    "number": "1205393253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6259 108TH ST APT 5H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751314",
            "telephone_number": "917-972-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6259 108TH ST APT 5H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751314",
            "telephone_number": "917-972-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BM NURSE PRACTITIONER IN FAMILY HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A",
        "authorized_official_last_name": "MOSHEYEV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "917-972-4458"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.