Prem Shanker Misra, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

109522 Issued in NY

Practice address

11247 Queens Blvd
Ste 108
Forest Hills, NY 11375-7417

Phone

(718) 793-3838

Fax

(516) 352-2025

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: premmisra@whmc.allscriptsdirect.net

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.

• Wyckoff Heights Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1700886322
  NPD
• Wyckoff Medical Services, P C

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1558308411
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366443863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CHERRYWOOD DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402209",
            "telephone_number": "516-352-2025",
            "fax_number": "516-352-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11247 QUEENS BLVD",
            "address_2": "STE 108",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757417",
            "telephone_number": "718-793-3838",
            "fax_number": "516-352-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISRA",
        "first_name": "PREM",
        "middle_name": "SHANKER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "109522",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "109522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "89979",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00194312",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eftekhar Miri, M.A.
• Yakub Mirzakandov
• Rachel Mirzokandov
• Rebecca Mirzokandov
• Rona Mishiyev
• Mitchell Rubin DC PC
• Crystal Mitchell
• Sheron D Mitchell
• Emanuel Mizrahi, DDS
• Stella Mizrakhi, LCSW

• Gastroenterology Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.