Individual provider Active NPI

Tatyana Nagornaia, M.D.

  • Psychiatry Physician
  • Staten Island, NY
National Provider Identifier
1629262076
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
249140 Issued in NY
Practice address
777 Seaview Ave BLDG 10
Staten Island, NY 10305-3409
Phone
(781) 667-8222
NPI assigned
Aug 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 249140 NY Primary

Addresses

Primary practice location

777 Seaview Ave BLDG 10
Staten Island, NY 10305-3409

Mailing address

777 Seaview Ave BLDG 10
Staten Island, NY 10305-3409
Phone (718) 667-2822

Other practice location 1

777 Seaview Ave
Staten Island, NY 10305-3409
Phone (718) 667-2822

Other names 1

  • Dr. Tatyana Nagornaia Professional name

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
I20080815000528 NY Practitioner - Psychiatry 3577638170 Reassigns benefits to 3 organizations
Practice locations: Staten Island, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249140NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Faculty Practice Plan CurrentSince Jul 6, 2019 Accepting new patients
Maimonides Medical Center Current Accepting new patients
North Shore - Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients
Maimonides Department of Psychiatry FPP Psychiatry CurrentSince Jun 1, 2008 Accepting new patients
North Shore-Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients
Anesthesiology Associates of Boro Park, LLP Past Accepting new patients
Nika Medical, P.C. PastSince Nov 1, 2016 Accepting new patients
MMC OB-GYN Faculty Practice Plan Past Accepting new patients

Locations

4802 10th Ave
#C
Brooklyn, NY 11219
Phone (718) 283-8163

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

920 48th St
Ste 1234
Brooklyn, NY 11219

300 Community Dr
Plandome, NY 11030

777 Seaview Ave
Staten Island, NY 10305
Phone (718) 667-2300

777 Seaview Ave
Bldg 10
Staten Island, NY 10305
Phone (718) 226-6279

Interoperability endpoints

  • Direct secure messaging: tatyananagornaia@mai.allscriptsdirect.net
  • Direct secure messaging: tatyananagornaia@nslijmedgr.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/AEHEAA

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1629262076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE BLDG 10",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053409",
            "telephone_number": "718-667-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 SEAVIEW AVE BLDG 10",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053409",
            "telephone_number": "781-667-8222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053409",
            "country_code": "US",
            "telephone_number": "718-667-2822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAGORNAIA",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "249140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TATYANA",
            "last_name": "NAGORNAIA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.