Individual provider Active NPI

Konstantin Nikiforov, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1407967482
Registry record updated Feb 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
223494 Issued in NY
Practice address
20 E 46TH St RM 1200
New York, NY 10017-9246
Phone
(646) 850-2290
Fax
(646) 850-2295
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 223494 NY Primary

Addresses

Primary practice location

20 E 46TH St RM 1200
New York, NY 10017-9246

Mailing address

65 Oceana Dr E
Apt. 4B
Brooklyn, NY 11235-6686
Phone (718) 577-7783

Other practice location 1

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-4408

Other identifiers 1

IdentifierTypeStateIssuer
02258717MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040330001059 NY Practitioner - Geriatric Psychiatry 4880686161 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Psychiatry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr. Iospa Psychiatry Consulting, P.C.Group PAC ID 3971679697, 14 clinicians

Practice addresses (Care Compare)

28 W 44TH St
Suite 714
New York, NY 10036-7406
Phone (646) 383-7575

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223494NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Healthcare Services PLLC CurrentSince Dec 11, 2013 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Aug 21, 2011 Accepting new patients
Hospitalist Healthcare Services PLLC CurrentSince Dec 11, 2013 Accepting new patients
Hospitalist Healthcare Services PLLC Current Accepting new patients
Dr. Iospa Psychiatry Consulting, P.C. Psychiatry CurrentSince May 28, 2018 Accepting new patients
Beth Israel Medical Center Past Accepting new patients
University Group Medical Associates, P.C Psychiatry Past Accepting new patients
Beth Israel Medical Center Psychiatry & Behavioral Science Past Accepting new patients
Galynker Family Center for Bipolar Disorder Psychiatry PastSince Feb 16, 2020 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

420 E 76th St
New York, NY 10021
Phone (212) 434-5300

1090 Amsterdam Ave
Fl 16
New York, NY 10025
Phone (212) 523-5089

1060 Amsterdam Ave
New York, NY 10025
Phone (212) 316-7700

100 Lake Rd
Vly Cottage, NY 10989
Phone (845) 268-6813

3 Barker Ave
Fl 4
White Plains, NY 10601
Phone (914) 949-7900

Organizations & group practices 9

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581206400000",
    "number": "1407967482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 OCEANA DR E",
            "address_2": "APT. 4B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356686",
            "telephone_number": "718-577-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E 46TH ST RM 1200",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100179246",
            "telephone_number": "646-850-2290",
            "fax_number": "646-850-2295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 Ocean Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112357745",
            "country_code": "US",
            "telephone_number": "718-616-4408",
            "fax_number": "718-616-4105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIKIFOROV",
        "first_name": "KONSTANTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-02-09",
        "certification_date": "2020-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "223494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02258717",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.