Individual provider Active NPI

Pavel Mukhin

  • Case Manager/Care Coordinator
  • Brooklyn, NY
National Provider Identifier
1780365080
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
704 Avenue X FL 2
Brooklyn, NY 11235-6121
Phone
(917) 912-9055
NPI assigned
Jul 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

704 Avenue X FL 2
Brooklyn, NY 11235-6121

Mailing address

2942 W 5TH St Apt 4C
Brooklyn, NY 11224-3806
Phone (917) 912-9055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1780365080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2942 W 5TH ST APT 4C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112243806",
            "telephone_number": "917-912-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 AVENUE X FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356121",
            "telephone_number": "917-912-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKHIN",
        "first_name": "PAVEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

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

Verify at the official NPI Registry.