Individual provider Active NPI

Nader Kameel Mishreki, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1386654770
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
188422 Issued in NY
Practice address
1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone
(800) 376-5566
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 188422 NY Primary

Addresses

Primary practice location

1545 Atlantic Ave
Brooklyn, NY 11213-1122

Mailing address

PO Box 29889
New York, NY 10087-9889
Phone (800) 376-5566

Other identifiers 1

IdentifierTypeStateIssuer
01695445MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160616000550 NJ Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4486945763

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
188422NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ijkg Opco LLC Current Accepting new patients
Interfaith Radiology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nader.mishreki@direct.bayonnemedicalcenter.md

Organizations & group practices 2

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386654770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29889",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100879889",
            "telephone_number": "800-376-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112131122",
            "telephone_number": "800-376-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHREKI",
        "first_name": "NADER",
        "middle_name": "KAMEEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "188422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01695445",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.