Yadid Nisimov, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

310828 Issued in NY

Practice address

3709 Flatlands Ave
Brooklyn, NY 11234-3507

Phone

(718) 444-7766

NPI assigned

Aug 9, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Excel Medical PC

  • Family Medicine Physician
  • Flushing, NY
  • NPI 1003005083
  NPD (past)

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1508594474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 108TH ST APT 3E",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751321",
            "telephone_number": "646-301-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343507",
            "telephone_number": "718-444-7766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6309 108th St Apt 3E",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113751321",
            "country_code": "US",
            "telephone_number": "646-301-7259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISIMOV",
        "first_name": "YADID",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-09",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Junko Nishita
• Margarita Nisimbaum
• Amnun Nisimov, OT
• Diana Nisimov, PHARMD
• Nikadam Nisimov
• Nisimova Quality Family Care
• Bella Nisimova, FNP
• Khalida Nisimova, PHARMD
• Nisma, PLLC LCSW
• Michael Nisnevitz

• Adult Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.