Individual provider Active NPI

Khevsi Plishtiyeva, NP

  • Family Nurse Practitioner
  • Forest Hills, NY
National Provider Identifier
1508532581
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F353473-01 Issued in NY
Practice address
10255 63Rd Rd
Forest Hills, NY 11375-1048
Phone
(347) 201-4664
NPI assigned
Aug 19, 2021
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F353473-01 NY Primary

Addresses

Primary practice location

10255 63Rd Rd
Forest Hills, NY 11375-1048

Mailing address

7503 192ND St
Fresh Meadows, NY 11366-1859
Phone (347) 571-3963

Other practice location 1

1530 Bedford Ave Fl 2
Brooklyn, NY 11216-4117
Phone (646) 849-9577

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
I20241106000657 NY Practitioner - Nurse Practitioner 3870027451 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F353473-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Medical Care PC CurrentSince Aug 22, 2024 Accepting new patients

Locations

1530 Bedford Ave
Fl 2
Brooklyn, NY 11216
Phone (347) 888-9138

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": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1508532581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7503 192ND ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661859",
            "telephone_number": "347-571-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10255 63RD RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751048",
            "telephone_number": "347-201-4664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1530 Bedford Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112164117",
            "country_code": "US",
            "telephone_number": "646-849-9577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLISHTIYEVA",
        "first_name": "KHEVSI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F353473-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.