Alan Leon Nissenbaum, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

177636 Issued in NY

Practice address

3915 Avenue V Ste 104
Brooklyn, NY 11234-5156

Phone

(718) 252-8440

NPI assigned

Feb 16, 2007

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

Other identifiers 1

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

Specialty

Internal MedicineAlso: Nephrology

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Kings Highway Dialysis Dialysis facility, Brooklyn, NY, CCN 332821
• DaVita Dyker Heights Dialysis Center Dialysis facility, Brooklyn, NY, CCN 332596

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Alan L Nissenbaum Medical Services PC

  • Nephrology Physician
  • Brooklyn, NY
  • NPI 1528254067
  NPD (past) Authorized official
• Maimonides Faculty Practice Plan

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1053344846
  NPD (past)

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

• Knickerbocker Dialysis Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brooklyn, NY
  • NPI 1043839269

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1295879120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2152 RALPH AVE # 428",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345406",
            "telephone_number": "718-998-7363",
            "fax_number": "718-998-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 AVENUE V STE 104",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345156",
            "telephone_number": "718-252-8440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1636 E 14th St",
            "address_2": "Suite 114",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112291100",
            "country_code": "US",
            "telephone_number": "718-998-7363",
            "fax_number": "718-998-7592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1435 86th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112283435",
            "country_code": "US",
            "telephone_number": "718-256-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISSENBAUM",
        "first_name": "ALAN",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "177636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01851147",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rivka C Nissel, LMSW
• Isaac Nissen, MS SP ED
• Jordan Nissen
• Miriam Nissen
• Neal B Nissen, D.D.S.
• Andrea Nissenbaum
• Simon Nissim, BA
• Micah Joel Nite, M.D.
• Nitin D.Narkhede, MD,LLC
• Leon Abramovich Nitkin, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.