NPIMap

Individual provider Active NPI

Mani Ushyarov, M.D.

  • Internal Medicine Physician
  • Rego Park, NY
National Provider Identifier
1326000498
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
201962 Issued in NY
Practice address
9785 Queens Blvd
Rego Park, NY 11374-3319
Phone
(718) 261-9100
Fax
(718) 897-2915
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 201962 NY Primary

Addresses

Primary practice location

9785 Queens Blvd
Rego Park, NY 11374-3319

Mailing address

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Other identifiers 1

IdentifierTypeStateIssuer
01843663MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mushyarov25895@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090409000418 NY Practitioner - Diagnostic Radiology 6204983158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6923

9777 Queens Blvd
Rego Park, NY 11374-3335
Phone (718) 261-9100

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201962NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Internal Medicine CurrentSince May 1, 2011 Accepting new patients
New York University Internal Medicine CurrentSince May 1, 2011 Accepting new patients
New York University Past Accepting new patients
Nyumc Radiology Associates Past Accepting new patients

Locations

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Interoperability endpoints

  • Direct secure messaging: mushyarov25895@nyumc.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1326000498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9785 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743319",
            "telephone_number": "718-261-9100",
            "fax_number": "718-897-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9785 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743319",
            "telephone_number": "718-261-9100",
            "fax_number": "718-897-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USHYAROV",
        "first_name": "MANI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "201962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01843663",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mushyarov25895@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "9785 Queens Blvd",
            "city": "Rego Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113743319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.