Dmitry Lisenenkov, M.D.

Primary specialty

Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X

License

25MA11111600 Issued in NJ

Practice address

475 Seaview Ave
Cardiothoracic ICU
Staten Island, NY 10305

Phone

(718) 775-7770

NPI assigned

Jul 7, 2008

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

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Internal MedicineAlso: Critical Care (Intensivists)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Critical Care Physicians of New Jersey PCGroup PAC ID 5698931699, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002
• Raritan Bay Medical Center Hospital, Perth Amboy, NJ, CCN 310039

Merit-based Incentive Payment System (MIPS)

Final score

98.51 of 100Reported as apm

Quality

84.27

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmitrylisenenkov@mai.allscriptsdirect.net

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.

• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  Medicare reassignment Care Compare group NPD
• Critical Care Physicians of New Jersey PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Turnersville, NJ
  • NPI 1154682680
  Medicare reassignment Care Compare group NPD
• Good Samaritan Hospital Medical Center

  • Physician Assistant
  • West Islip, NY
  • NPI 1518901180
  Medicare reassignment NPD
• Maimonides Faculty Practice Plan

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1053344846
  Medicare reassignment NPD
• Maimonides Medical Center - Maimo Criticare FPP

  • Critical Care Medicine (Internal Medicine) Physician
  • Brooklyn, NY
  • NPI 1265547178
  Medicare reassignment NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152

  Critical Care Medicine

  Medicare reassignment NPD
• Nassau Health Care Corporation

  • General Acute Care Hospital
  • East Meadow, NY
  • NPI 1902822992
  Medicare reassignment NPD
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• Physicians of University Hospital, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Staten Island, NY
  • NPI 1417901323
  Medicare reassignment NPD
• Ccmma NJ LLC

  • Critical Care Medicine (Anesthesiology) Physician
  • Passaic, NJ
  • NPI 1124543095
  Medicare reassignment NPD
• Good Samaritan Hospital Medical

  • Critical Care Medicine (Internal Medicine) Physician
  • West Islip, NY
  • NPI 1548501620
  NPD
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD

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

• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Old Bridge, NJ
  • NPI 1356828172
  Care Compare affiliation
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Perth Amboy, NJ
  • NPI 1790297455
  Care Compare affiliation
• Newark Beth Israel Medical Center Inc

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215027966
  Care Compare affiliation

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1679736953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-775-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "address_2": "CARDIOTHORACIC ICU",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-775-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISENENKOV",
        "first_name": "DMITRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "249407",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA11111600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lippe
• Kelly Lippman, M.A., CCC-SLP
• Maria C. Liranzo
• Polina Lirman, PHARM D
• Ana Lisencu, RN
• Mary Elizabeth Lisi, NP, CNM
• Valerie Lisojo-Ponemon, RDCS
• Jordan Lissauer, DMD
• Jennifer Lista
• Listening Carefully Individual & Family Counseling Services

• Critical Care Medicine (Anesthesiology) Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Critical Care Medicine (Anesthesiology) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.