Mo-Ma Medical PLLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

MO-MA MEDICAL PLLC

Practice address

925 Park Ave
New York, NY 10028-0210

Phone

(212) 737-8700

NPI assigned

Feb 13, 2023

Organization subpart

No

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

Authorized official

Name

Grigoriy MashkevichNPI 1346398690

Title

Authorized Official

Phone

(212) 737-8700

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Grigoriy Mashkevich, M.D.

  • Facial Plastic Surgery Physician
  • Forest Hills, NY
  • NPI 1346398690

  Otolaryngology

  Medicare reassignment NPD Authorized official
• Anna Frants

  • Otolaryngology/Facial Plastic Surgery Physician
  • Brooklyn, NY
  • NPI 1902354889
  Medicare reassignment NPD

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1639876485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280210",
            "telephone_number": "212-737-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280210",
            "telephone_number": "212-737-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MO-MA MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "MASHKEVICH",
        "authorized_official_first_name": "GRIGORIY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "212-737-8700"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MMC Manhattan Practice at Park Ave
• MMG Medical Group, P.a.
• MNK Pharmacy Inc (Chateau Drug & Homecare)
• MNS Pharmacy Corp.
• Mntefiore Medical Center
• Aidan Chapman Mo, LMSW
• Cecilia Mo, MD
• Edwin Mo
• Elizabeth Mo, PHARMD
• Lan Mo, M.D.

• Otolaryngology Physician in New York, NY
• Providers in New York, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.