Individual provider Active NPI

Kiki Kadianakis, D.O.

  • Family Medicine Physician
  • Long Island City, NY
National Provider Identifier
1265551501
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
203957 Issued in NY
Practice address
4604 31St Ave
Suite B
Long Island City, NY 11103-1842
Phone
(718) 545-2100
Fax
(718) 545-1900
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 203957 NY Primary

Addresses

Primary practice location

4604 31St Ave
Suite B
Long Island City, NY 11103-1842

Mailing address

2202 Steinway St
Astoria, NY 11105-1875
Phone (718) 423-0808

Other identifiers 1

IdentifierTypeStateIssuer
02985546MedicaidNY

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
I20040401000086 NY Practitioner - Family PracticePractitioner - Physical Medicine and Rehabilitation 0941292791 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Physical Medicine and Rehabilitation
Education
New York College of Osteo Medicine of New York Institute of Technology, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3590

Hospital & facility affiliations

  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Long Island Jewish Health Care Inc CurrentSince Nov 22, 2010 Accepting new patients
North Shore-Lij Medical PC Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
North Shore Long Island Jewish Healthcare Family Medicine CurrentSince Nov 22, 2010 Accepting new patients
Boro Medical, P.C. Family Medicine Past Accepting new patients
Boro Medical, P.C. Family Medicine Past Accepting new patients
Ark Medical Associates PC PastSince Oct 16, 2009 Accepting new patients
Kzark Medical PC Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

2202 Steinway St
Long Is City, NY 11105
Phone (718) 423-0808

300 Community Dr
Ste 2
Manhasset, NY 11030
Phone (516) 562-3590

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: kikikadianakis@nslijmedgr.allscriptsdirect.net

Organizations & group practices 7

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 5

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1265551501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051875",
            "telephone_number": "718-423-0808",
            "fax_number": "718-204-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4604 31ST AVE",
            "address_2": "SUITE B",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111031842",
            "telephone_number": "718-545-2100",
            "fax_number": "718-545-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADIANAKIS",
        "first_name": "KIKI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "203957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02985546",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.