Takeshi Nishi

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

351012 Issued in LA

Practice address

506 6TH St
Brooklyn, NY 11215-3609

Phone

(650) 238-7869

NPI assigned

Feb 29, 2024

Last updated

Jul 31, 2026By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Beacon Medical Group Michigan Inc

  dba Beacon Medical Group Michigan

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beacon Kalamazoo Inc

  dba Beacon Kalamazoo

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Care Compare affiliation

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1518724244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3308 W MAIN ST APT 201",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490066011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "650-238-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHI",
        "first_name": "TAKESHI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-29",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "351012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518724244",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Polina Nisanova
• Khamiya Nisbett, CCC-SLP
• Noelle Nisco
• Iliya Nisen, PHARM D
• Vladlena Nisevich, PA
• Junko Nishita
• Margarita Nisimbaum
• Amnun Nisimov, OT
• Diana Nisimov, PHARMD
• Nikadam Nisimov

• Interventional Cardiology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Interventional Cardiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.