Individual provider Active NPI

Stanislav Kulishov, MD

  • Neurology Physician
  • Brooklyn, NY
National Provider Identifier
1497857502
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
208948 Issued in NY
Practice address
1833 East 13 Street
Ste 1a
Brooklyn, NY 11229
Phone
(718) 627-3939
Fax
(718) 627-8737
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 208948 NY Primary

Addresses

Primary practice location

1833 East 13 Street
Ste 1a
Brooklyn, NY 11229

Mailing address

1833 East 13 Street
Ste 1a
Brooklyn, NY 11229
Phone (718) 627-3939

Other identifiers 1

IdentifierTypeStateIssuer
01817945MedicaidNY

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
I20051122000257 NY Practitioner - Neurology 5890714646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1833 E 13TH St
Suite 1a
Brooklyn, NY 11229-2885
Phone (718) 627-3939

Merit-based Incentive Payment System (MIPS)

Final score
96.91 of 100Reported as individual
Quality
85.71
Improvement activities
40
Cost
75.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208948NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanislav Kulishov Physician P.C. CurrentSince Nov 1, 2000 Accepting new patients

Locations

1833 E 13th St
Ste 1A
Brooklyn, NY 11229
Phone (718) 627-3939

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497857502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 EAST 13 STREET",
            "address_2": "STE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-627-3939",
            "fax_number": "718-627-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 EAST 13 STREET",
            "address_2": "STE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-627-3939",
            "fax_number": "718-627-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULISHOV",
        "first_name": "STANISLAV",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "208948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01817945",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.