NPIMap

Individual provider Active NPI

Emmanuel Nectarios Moustakakis, M.D.

  • Interventional Cardiology Physician
  • Flushing, NY
National Provider Identifier
1457514598
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
230890 Issued in NY
Practice address
5645 Main St
New York Hospital Queens, Cardiac Cath Lab
Flushing, NY 11355-5045
Phone
(718) 670-2516
Fax
(718) 445-7473
NPI assigned
Jul 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 230890 NY
Interventional Cardiology Physician 207RI0011X 230890 NY Primary

Addresses

Primary practice location

5645 Main St
New York Hospital Queens, Cardiac Cath Lab
Flushing, NY 11355-5045

Mailing address

5645 Main St
New York Hospital Queens, Cardiac Cath Lab
Flushing, NY 11355-5045
Phone (718) 670-2516

Other identifiers 1

IdentifierTypeStateIssuer
03111566MedicaidNY

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address enm9004@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090709000142 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3779635511 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2002
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)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

250 Patchogue Yaphank Rd
Suite 5
East Patchogue, NY 11772-4862
Phone (631) 654-3330

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

297 Mineola Blvd
Mineola, NY 11501-1502
Phone (516) 294-1377

Hospital & facility affiliations

  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043
  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting19
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230890NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 1, 2011 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Nov 1, 2011 Accepting new patients
New York University Cardiovascular Disease CurrentSince Jun 1, 2025 Accepting new patients
New York University Cardiovascular Disease CurrentSince Jun 1, 2025 Accepting new patients
Newyork-Presbyterian-Queens Past Accepting new patients

Locations

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

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

Interoperability endpoints

  • Direct secure messaging: enm9004@direct.nyp.org
  • Direct secure messaging: emoustakakis720463@nyumc.direct-ci.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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 21

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 21

NPI Registry JSON

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

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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1457514598",
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            "country_name": "United States",
            "address_purpose": "MAILING",
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            "address_1": "5645 MAIN ST",
            "address_2": "NEW YORK HOSPITAL QUEENS, CARDIAC CATH LAB",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-2516",
            "fax_number": "718-445-7473"
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            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-670-2516",
            "fax_number": "718-445-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSTAKAKIS",
        "first_name": "EMMANUEL",
        "middle_name": "NECTARIOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "230890",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "230890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03111566",
            "state": "NY"
        }
    ],
    "endpoints": [
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            "endpointTypeDescription": "FHIR URL",
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            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
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            "contentTypeDescription": "Other",
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            "address_1": "5645 Main St",
            "address_2": "New York Hospital Queens, Cardiac Cath Lab",
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            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
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            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St",
            "address_2": "New York Hospital Queens, Cardiac Cath Lab",
            "city": "Flushing",
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            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "enm9004@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "5645 Main St",
            "address_2": "New York Hospital Queens, Cardiac Cath Lab",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113555045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.