Individual provider Active NPI

Viktoriya Lasiychuk, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1457586257
Registry record updated May 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013228 Issued in NY
Practice address
111 E 210TH St
Silver Zone - 6TH Floor
Bronx, NY 10467-2401
Phone
(718) 920-2961
NPI assigned
May 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013228 NY Primary

Addresses

Primary practice location

111 E 210TH St
Silver Zone - 6TH Floor
Bronx, NY 10467-2401

Mailing address

14 Butler PL
Staten Island, NY 10305-1805
Phone (718) 556-5348

Other names 1

  • Viktoriya Sobol Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090902000615 NY Practitioner - Physician Assistant 4486709037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Jul 27, 2021 Accepting new patients
Montefiore Medical Center Past Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: vlasiychuk69263@northwell.direct-ci.com

Organizations & group practices 4

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": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1457586257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BUTLER PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051805",
            "telephone_number": "718-556-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "address_2": "SILVER ZONE - 6TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASIYCHUK",
        "first_name": "VIKTORIYA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIKTORIYA",
            "last_name": "SOBOL",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.