Individual provider Active NPI

Uriel Mirzakandov, M.D.

  • Pediatrics Physician
  • Fresh Meadows, NY
National Provider Identifier
1316276447
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
260047 Issued in NY
Practice address
6927 164TH St
Fresh Meadows, NY 11365-3195
Phone
(718) 261-3222
NPI assigned
Dec 20, 2009
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 260047 NY Primary

Addresses

Primary practice location

6927 164TH St
Fresh Meadows, NY 11365-3195

Mailing address

14433 69TH Rd
Flushing, NY 11367-1701
Phone (212) 444-8933

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
I20140327002008 NY Practitioner - Pediatric Medicine 0941431324 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Professional Medical Services, PC Pediatrics CurrentSince Mar 1, 2015 Accepting new patients
Wyckoff Heights Medical Center Current Accepting new patients
Dr Uriel Medical PLLC Pediatrics CurrentSince Aug 1, 2018 Accepting new patients

Locations

1411 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 907-4301

1419 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 455-4909

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

6927 164th St
#A
Fresh Meadows, NY 11365

Networks

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

Interoperability endpoints

  • Direct secure messaging: uriel.mirzakandov.1@18171.direct.athenahealth.com
  • Direct secure messaging: urielmirzakandov@whmc.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1261267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1316276447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14433 69TH RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671701",
            "telephone_number": "212-444-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6927 164TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653195",
            "telephone_number": "718-261-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZAKANDOV",
        "first_name": "URIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-20",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "260047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.