NPIMap

Individual provider Active NPI

Leonid Iskhakov, P.A.

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1700031770
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012887 Issued in NY
Practice address
2310 65TH St
1St Floor
Brooklyn, NY 11204-4088
Phone
(718) 648-1328
NPI assigned
Nov 18, 2008
Last updated
Nov 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 012887 NY Primary

Addresses

Primary practice location

2310 65TH St
1St Floor
Brooklyn, NY 11204-4088

Mailing address

1041 Arcadian Way
Fort Lee, NJ 07024-6349
Phone (917) 613-4087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090521000113 NY Practitioner - Physician Assistant 1153470190 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Medical Care PCGroup PAC ID 5597056382, 4 clinicians

Practice addresses (Care Compare)

10255 63Rd Rd
Forest Hills, NY 11375-1048
Phone (347) 808-0346

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
012887NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mujibur R. Majumder, MD, PC Past Accepting new patients
Miriam Kanter MD PC Past Accepting new patients
SK Neurology PC PastSince Nov 17, 2019 Accepting new patients
Madison Medical Practice P.C. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1226966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1700031770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 ARCADIAN WAY",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246349",
            "telephone_number": "917-613-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 65TH ST",
            "address_2": "1ST FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044088",
            "telephone_number": "718-648-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISKHAKOV",
        "first_name": "LEONID",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-18",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.