Vyacheslav Nisonov, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

041926 Issued in NY

Practice address

49 Montrose Ave
Brooklyn, NY 11206-2580

Phone

(718) 473-3808

NPI assigned

Sep 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Slava Nisonov Professional name

Medicare fee-for-service enrollment

Enrolled in NY, AZ2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Core Physical Therapy Services PC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1184269755
  Medicare reassignment NPD
• Esd PT OT & SLP PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1003383308
  Medicare reassignment NPD
• Arizona Luna Care Physical Therapy, LLC

  • Physical Therapist
  • Peoria, AZ
  • NPI 1629698147
  Medicare reassignment NPD
• Petkov Bodywork Therapy, LLC

  • Physical Rehabilitation Occupational Therapist
  • Glendale, AZ
  • NPI 1386271690
  Medicare reassignment NPD
• Allone Healthcare LLC

  • Physical Therapy Clinic/Center
  • Phoenix, AZ
  • NPI 1952122061
  NPD

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1386294577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9740 62ND DR APT 7C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741324",
            "telephone_number": "347-677-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 MONTROSE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112062580",
            "telephone_number": "718-473-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISONOV",
        "first_name": "VYACHESLAV",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SLAVA",
            "last_name": "NISONOV",
            "credential": "DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nisimova Quality Family Care
• Bella Nisimova, FNP
• Khalida Nisimova, PHARMD
• Nisma, PLLC LCSW
• Michael Nisnevitz
• Yuliya M Nisonova, LMSW
• Vanessa Anne Nisperos, LMSW
• Carly Jessica Nisse, LMSW
• Rivka C Nissel, LMSW
• Isaac Nissen, MS SP ED

• Physical Therapist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.