Individual provider Active NPI

Vinay N Kikkeri, M.D.

  • Vascular & Interventional Radiology Physician
  • Staten Island, NY
National Provider Identifier
1396722708
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
250734 Issued in NY
Practice address
360 Bard Ave
Staten Island, NY 10310-1666
Phone
(718) 876-2000
Fax
(718) 876-2012
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 250734 NY
Vascular & Interventional Radiology Physician 2085R0204X 250734 NY Primary

Addresses

Primary practice location

360 Bard Ave
Staten Island, NY 10310-1666

Mailing address

360 Bard Ave
Staten Island, NY 10310-1666
Phone (718) 876-2000

Other identifiers 1

IdentifierTypeStateIssuer
02458166MedicaidNY

Other names 1

  • Kikkeri N Vinaya Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031105000018 NY Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 4981516291 Reassigns benefits to 2 organizations
I20260311003306 FL Practitioner - Diagnostic Radiology 4981516291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

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 Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Mar 13, 2014 Accepting new patients
New York University CurrentSince Mar 13, 2014 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

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

360 Bard Ave
Staten Island, NY 10310
Phone (718) 876-2000

4849 Arthur Kill Rd
#P
Staten Island, NY 10309
Phone (718) 876-2000

3917 Richmond Ave
Staten Island, NY 10312
Phone (718) 876-2000

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: kvinaya90407@nyumc.direct-ci.com

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.

Hospital & facility affiliations 9

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1396722708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101666",
            "telephone_number": "718-876-2000",
            "fax_number": "718-876-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101666",
            "telephone_number": "718-876-2000",
            "fax_number": "718-876-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIKKERI",
        "first_name": "VINAY",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "250734",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "250734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02458166",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIKKERI",
            "last_name": "VINAYA",
            "middle_name": "N",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.