Alexander Niyazov, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2277-83 Coney Island Ave
Brooklyn, NY 11223

Phone

(212) 305-2500

NPI assigned

Aug 26, 2016

Last updated

May 12, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• An Physician Assistant PC

  • Physician Assistant
  • Smithtown, NY
  • NPI 1609456649
  NPD Authorized official
• Optum Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Jericho, NY
  • NPI 1285975797
  Medicare reassignment
• LR Medical PLLC

  • Interventional Pain Medicine Physician
  • Brooklyn, NY
  • NPI 1760808802
  NPD (past)

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1265988778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 CONEY ISLAND AVE STE 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233337",
            "telephone_number": "718-998-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277-83 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11223",
            "telephone_number": "212-305-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIYAZOV",
        "first_name": "ALEXANDER",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-26",
        "last_updated": "2021-05-12",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martine Nivose
• Alexis Nixon
• Lucia J. Nixon, MD
• Marlene A Nixon, RN
• Hina Niyazi, MD
• Alexander Niyazov, PHARMD
• Eli Niyazov
• Gabriella Niyazov, DDS
• Merik Niyazov, DDS
• Tatyana Niyazov, D.D.S.

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.