Individual provider Active NPI

Michael Gugnishev, NP

  • Gerontology Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1245822204
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ15120800 Issued in NJ
Practice address
4808 Fort Hamilton Pkwy
Brooklyn, NY 11219
Phone
(718) 283-6000
NPI assigned
Feb 10, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ15120800 NJ Primary
Adult Health Nurse Practitioner 363LA2200X F310109-01 NY

Addresses

Primary practice location

4808 Fort Hamilton Pkwy
Brooklyn, NY 11219

Mailing address

2222 Ocean Ave Apt 4G
Brooklyn, NY 11229-2272
Phone (917) 349-9502

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL SCM

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
I20240226003867 NY Practitioner - Nurse Practitioner 1850736133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maimonides Faculty Practice PlanGroup PAC ID 7012808348, 251 clinicians

Practice addresses (Care Compare)

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Hospital & facility affiliations

  • Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F310109-01NYMDAdult Health Nurse Practitioner
26NJ15120800NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Medical Care PC CurrentSince Mar 5, 2024 Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Dec 6, 2023 Accepting new patients
Maimonides Medical Center Division of Otolaryngology FPP PastSince Oct 1, 2013 Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

1250 57th St
Brooklyn, NY 11219
Phone (718) 283-5700

745 64th St
Brooklyn, NY 11220
Phone (718) 765-2570

6300 8th Ave
Brooklyn, NY 11220
Phone (718) 765-2600

4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

948 48th St
Brooklyn, NY 11219
Phone (718) 283-7219

919 49th St
Brooklyn, NY 11219
Phone (718) 283-6260

6323 7th Ave
Brooklyn, NY 11220
Phone (718) 283-6980

565 Abbott Rd
Rm 8632
Buffalo, NY 14220
Phone (607) 798-5671

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1245822204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 OCEAN AVE APT 4G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292272",
            "telephone_number": "917-349-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4808 FORT HAMILTON PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGNISHEV",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-10",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ15120800",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310109-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SCM",
            "affiliation": "N",
            "endpointDescription": "Computer Program",
            "address_1": "4808 Fort Hamilton Pkwy",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.