Individual provider Active NPI

Moisey Simkhayev, NP

  • Adult Health Nurse Practitioner
  • Elmhurst, NY
National Provider Identifier
1356717342
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
307403 Issued in NY
Practice address
4047 95TH St Apt B
Elmhurst, NY 11373
Phone
(646) 559-6699
NPI assigned
Aug 13, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 307403 NY Primary

Addresses

Primary practice location

4047 95TH St Apt B
Elmhurst, NY 11373

Mailing address

4047 95TH St Apt B
Elmhurst, NY 11373-1715
Phone (646) 559-6699

Other practice location 1

9701 66th Ave
Rego Park, NY 11374-4245
Phone (718) 406-7805

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161104001452 NY Practitioner - Nurse Practitioner 5597043919 Reassigns benefits to 3 organizations
Practice locations: Elmhurst, NY; Rego Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adult Health NP Nyc PCGroup PAC ID 5294197513, 3 clinicians

Practice addresses (Care Compare)

4047 95TH St
Apt B
Elmhurst, NY 11373-1715
Phone (646) 559-6699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
307403NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Medical Concepts PC CurrentSince Aug 1, 2017 Accepting new patients
Advanced Medical Concepts PC CurrentSince Aug 1, 2017 Accepting new patients
Adult Health NP Nyc PC Adult Health CurrentSince Dec 2, 2019 Accepting new patients

Locations

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

16110 Jamaica Ave
Ste 301
Jamaica, NY 11432
Phone (212) 404-8080

15031 Union Tpke
Kew Gardens Hills, NY 11367
Phone (347) 454-2050

9701 66th Ave
Rego Park, NY 11374
Phone (718) 275-5200

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1356717342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4047 95TH ST APT B",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731715",
            "telephone_number": "646-559-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4047 95TH ST APT B",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "646-559-6699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9701 66th Ave",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113744245",
            "country_code": "US",
            "telephone_number": "718-406-7805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMKHAYEV",
        "first_name": "MOISEY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-13",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "307403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.