Dmitriy V Kolesnik, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

214729 Issued in NY

Practice address

9530 Queens Blvd
Rego Park, NY 11374-1136

Phone

(718) 275-7860

Fax

(718) 275-7882

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nyc Medical and Neurodiagnostic PCGroup PAC ID 0941199327, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

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.

• Nyc Medical and Neurodiagnostic PC

  • Neurology Physician
  • Rego Park, NY
  • NPI 1669407185
  Medicare reassignment Care Compare group NPD Authorized official
• DK Total Medical PC

  • Family Medicine Physician
  • Rego Park, NY
  • NPI 1205843349

  Neurology

  NPD (past)
• Metropolitan Specialty Physicians

  • Urology Physician
  • Elmhurst, NY
  • NPI 1659589083
  NPD (past)
• Michael Z Weiner MDPC

  • Cardiovascular Disease Physician
  • Forest Hills, NY
  • NPI 1346325057
  NPD (past)
• Newyork-Presbyterian/Queens

  • Cardiovascular Disease Physician
  • Flushing, NY
  • NPI 1013960962

  Neurology

  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1851326367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9530 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741136",
            "telephone_number": "718-275-7860",
            "fax_number": "718-275-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9530 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741136",
            "telephone_number": "718-275-7860",
            "fax_number": "718-275-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLESNIK",
        "first_name": "DMITRIY",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "214729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0271GU",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE MEDICARE",
            "identifier": "01S641",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02196023",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0078AJ",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Rachael Kipen, RN
• Audrey Olivia Kirkland, D.P.T.
• Michele Kirschner, LMSW
• Leslie A Kizner, LCSW, CASAC
• Leslie Koffler
• Isaiah Yanlok Kong, LCSW
• Alyson Rose Koonin, MSW
• Paul M Koslow
• Kostko Medical PLLC
• Semyon Kostko, M.D.

• Neurology Physician in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.