Active NPI
Nasim Tishbi, DMD
- Endodontics
- Plainview, NY
National Provider Identifier
1417453986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 060771-01
- Practice address
- 100 Manetto Hill Rd Ste 206
Plainview, NY 11803-1311 - Phone
- (516) 490-8050
- Fax
- (516) 490-8051
- NPI assigned
- Apr 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 060771-01 | NY | Primary |
Addresses
Primary practice location
100 Manetto Hill Rd Ste 206
Plainview, NY 11803-1311
Mailing address
121 Dekalb Ave
Brooklyn, NY 11201-5425
Other practice location 1
79 Landing Ave
Smithtown, NY 11787-2748
Phone (163) 126-5616
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190129000472 | NY | Order and Referring Only - Dentist | 3375880404 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 060771-01 | NY | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nasim Tishbi DMD PC | Endodontics | Current | Accepting new patients |
Locations
100 Manetto Hill Rd
Ste 206
Plainview, NY 11803
Phone (516) 490-8050
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1417453986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 DEKALB AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112015425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MANETTO HILL RD STE 206",
"city": "PLAINVIEW",
"state": "NY",
"postal_code": "118031311",
"telephone_number": "516-490-8050",
"fax_number": "516-490-8051"
}
],
"practiceLocations": [
{
"address_1": "79 Landing Ave",
"address_purpose": "LOCATION",
"city": "Smithtown",
"state": "NY",
"postal_code": "117872748",
"country_code": "US",
"telephone_number": "163-126-5616",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TISHBI",
"first_name": "NASIM",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-03",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NY",
"license": "060771-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plainview, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.