NPIMap

Organization Active NPI

Medical Doctor Milena Kolesnikova PC

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1700404720
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL DOCTOR MILENA KOLESNIKOVA PC
Doing business as
Medical Doctor Milena Kolesnikova PC
Practice address
586 Midland Ave Ste B
Staten Island, NY 10306-5903
Phone
(646) 598-7791
NPI assigned
Jul 7, 2020
Last updated
Sep 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Authorized official

Name
Dr. Milena Kolesnikova, MDNPI 1285065557
Title
Owner
Phone
(980) 330-2025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

586 Midland Ave Ste B
Staten Island, NY 10306-5903

Mailing address

586 Midland Ave Ste B
Staten Island, NY 10306-5903
Phone (646) 598-7791

Other names 1

  • MEDICAL DOCTOR MILENA KOLESNIKOVA PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210408000537 NY Part B Supplier - Clinic/Group Practice 1254748320 Receives reassigned benefits from 11 practitioners
Practice locations: Brooklyn, NY; Staten Island, NY

National Provider Directory

National Provider Directory

Locations

587 Midland Ave
Staten Island, NY 10306
Phone (347) 201-5081

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1700404720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 MIDLAND AVE STE B",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065903",
            "telephone_number": "646-598-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 MIDLAND AVE STE B",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065903",
            "telephone_number": "646-598-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DOCTOR MILENA KOLESNIKOVA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-07",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "KOLESNIKOVA",
        "authorized_official_first_name": "MILENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-330-2025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL DOCTOR MILENA KOLESNIKOVA PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDICAL DOCTOR MILENA KOLESNIKOVA PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.