Individual provider Active NPI

Tatyana Kisina, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Brooklyn, NY
National Provider Identifier
1245265586
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
223341-1 Issued in NY
Practice address
3065 Brighton 14TH St
Brooklyn, NY 11235-5545
Phone
(718) 496-8755
Fax
(718) 375-2735
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 223341-1 NY Primary

Addresses

Primary practice location

3065 Brighton 14TH St
Brooklyn, NY 11235-5545

Mailing address

2806 East 23 St
#6A
Brooklyn, NY 11235
Phone (718) 496-8755

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040816000535 NY Practitioner - Physical Medicine and Rehabilitation 8022081314 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3065 Brighton 14TH St
Brooklyn, NY 11235-5545

3065 Brighton 14TH St
Brooklyn, NY 11235-5553
Phone (718) 496-8755

3514 Mermaid Ave
Suite 3
Brooklyn, NY 11224-1510
Phone (718) 496-8755

501 Brighton Beach Ave
FL 2
Brooklyn, NY 11235-6403
Phone (347) 702-8805

Merit-based Incentive Payment System (MIPS)

Final score
21.37 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
71.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
223341-1NYMDPain Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1245265586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 EAST 23 ST",
            "address_2": "#6A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "718-496-8755",
            "fax_number": "718-375-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 BRIGHTON 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355545",
            "telephone_number": "718-496-8755",
            "fax_number": "718-375-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISINA",
        "first_name": "TATYANA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": "223341-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.