Michael David Kisicki, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

328470 Issued in NY

Practice address

312 E 94TH St
New York, NY 10128-5604

Phone

(212) 423-3000

NPI assigned

May 24, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (2 of 5)

Networks

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

Interoperability endpoints

• Direct secure messaging: mkisicki393689@direct.dartmouth-hitchcock.org

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.

• Mount Sinai Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1932103413
  NPD (past)
• University of Connecticut Health Center

  • Clinical Medical Laboratory
  • Farmington, CT
  • NPI 1427031293
  NPD (past)

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1407067572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 E 94TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285604",
            "telephone_number": "212-423-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 E 94TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285604",
            "telephone_number": "212-423-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISICKI",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "328470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A96472",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vera Kishinevsky, PH.D
• Gabrielle Kishner, RD
• Samantha Rebekka Kishner
• Ronit N/a Kishon
• Mohamed Nazir Kishori, P.A.C.
• Sarit Kisin
• Alicia Halena Kiss, MHC-LP
• Christina Kiss, RN, OCN, ANP-BC
• Gary Kiss, CASAC-T
• Lawrence P Kiss, M.D.

• All providers in New York, NY
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.