Andrii Smolnikov, SA-C

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

P133128 Issued in NY

Practice address

4545 Center Blvd Apt Long
Long Island City, NY 11109-5901

Phone

(171) 875-3422

NPI assigned

Apr 26, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750464000000",
    "number": "1518655778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 CENTER BLVD APT LONG",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111095901",
            "telephone_number": "718-753-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CENTER BLVD APT LONG",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111095901",
            "telephone_number": "171-875-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLNIKOV",
        "first_name": "ANDRII",
        "name_prefix": "Mr.",
        "credential": "SA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-26",
        "last_updated": "2025-06-21",
        "certification_date": "2025-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": "21-689",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P133128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2025; 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.