Individual provider Active NPI

Nima Tishbi

  • Diagnostic Radiology Physician
  • New Hyde Park, NY
National Provider Identifier
1578097663
Registry record updated Sep 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D0093718 Issued in MD
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone
(718) 290-5651
NPI assigned
Apr 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0093718 MD Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1402

Mailing address

22 S Greene St
Baltimore, MD 21201-1544
Phone (718) 290-5651

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
I20230920003668 NY Practitioner - Diagnostic Radiology 2668850413 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albert Einstein College of Medicine of Yeshiva University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6000

100 E 77TH St
New York, NY 10075-1850

101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone (631) 675-4550

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

111 E 77TH St
New York, NY 10075-1850
Phone (212) 434-3966

1111 Marcus Ave
New Hyde Park, NY 11042-1034

1333 Heroes Way
Riverhead, NY 11901-2029
Phone (631) 727-2755

1333 Roanoke Ave
Riverhead, NY 11901-2029
Phone (631) 727-2755

221 Jericho Tpke
Syosset, NY 11791-4515
Phone (516) 496-2752

221 Jericho Turnpike
Syosset, NY 11791-4515
Phone (516) 496-6500

270 Park Ave
Huntington, NY 11743-2787
Phone (631) 351-2356

27005 75TH Ave
New Hyde Park, NY 11040-1402

27005 76TH Ave GF
New Hyde Park, NY 11040-1402
Phone (718) 470-7501

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

301 E Main St
Bay Shore, NY 11706-8408

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 666-1371

450 Lakeville Rd
New Hyde Park, NY 11042-1118
Phone (516) 470-8445

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980

496 County Rd
111 BLDG F1
Manorville, NY 11949-3388
Phone (631) 405-3240

496 County Rd 111
Manorville, NY 11949-3386
Phone (631) 405-3220

701 N Broadway
Sleepy Hollow, NY 10591-1020
Phone (914) 269-1914

711 Stewart Ave
Garden City, NY 11530-4731
Phone (516) 321-3499

Hospital & facility affiliations

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
  • NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043
  • NS/Lij HS Huntington Hospital Hospital, Huntington, NY, CCN 330045
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0093718MDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Faculty Medical Affiliates University Faculty Practice Corp CurrentSince Sep 4, 2023 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 19, 2023 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jul 19, 2023 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

9525 Queens Blvd
Frnt 2
Rego Park, NY 11374
Phone (718) 360-5522

1220 Hicksville Rd
Seaford, NY 11783

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: ntishbi68756@northwell.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664064000000",
    "number": "1578097663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "718-290-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "718-290-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISHBI",
        "first_name": "NIMA",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2022-09-25",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0093718",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.