Individual provider Active NPI

Milana Murdakhaev, NP

  • Pediatric Nurse Practitioner
  • New Hyde Park, NY
National Provider Identifier
1215577010
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383463 Issued in NY
Practice address
2001 Marcus Ave Ste W290
New Hyde Park, NY 11042-1098
Phone
(516) 465-5255
Fax
(718) 347-2240
NPI assigned
Jan 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 663321 NY
Pediatric Nurse Practitioner 363LP0200X 383463 NY Primary

Addresses

Primary practice location

2001 Marcus Ave Ste W290
New Hyde Park, NY 11042-1098

Mailing address

2001 Marcus Ave Ste W290
New Hyde Park, NY 11042-1098
Phone (516) 465-5255

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230501000489 NY Practitioner - Nurse Practitioner 6305201179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
663321NYMDRegistered Nurse
383463NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PM Pediatrics of Mamaroneck Past Accepting new patients
PM Pediatrics PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmurdakhaev315370@northwell.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1215577010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE STE W290",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421098",
            "telephone_number": "516-465-5255",
            "fax_number": "516-326-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE STE W290",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421098",
            "telephone_number": "516-465-5255",
            "fax_number": "718-347-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDAKHAEV",
        "first_name": "MILANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "663321",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.