Reina Joy Mizukoshi

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F383578 Issued in NY

Practice address

1400 Pelham Pkwy S
Bronx, NY 10461-1138

Phone

(858) 999-6050

NPI assigned

Jan 5, 2024

Sex

Female

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Wyckoff Professional Medical Services, PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1659710796
  Medicare reassignment NPD

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1710757265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 BROADWAY APT 12A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235827",
            "telephone_number": "858-999-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611138",
            "telephone_number": "858-999-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZUKOSHI",
        "first_name": "REINA JOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "NY",
            "license": "829659",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Fishbeck Miyazaki, M.D.
• Megan Marie Mizera, M.D.
• Daniel Mizrahi
• Michael Mizrahi
• Sheera Mizrahi, DMD
• MJM Pharmacy Inc (Eastchester Pharmacy)
• Katerina Mlejnkova
• MLK RX Group LLC (CaremoreRx Pharmacy)
• MLK RX Group LLC (Caremore Rx Pharmacy)
• Sarah Eagle Keenan Mlynarczyk, ATR, LCAT

• Pediatric Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.