Larisa Malisova, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

234484 Issued in NY

Practice address

420 Lyndale Ave
Staten Island, NY 10312-6131

Phone

(718) 967-5630

NPI assigned

May 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Geriatric Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Brooklyn Health Hospital, Brooklyn, NY, CCN 330196
• Staten Island Care Center Nursing home, Staten Island, NY, CCN 335561

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

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

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.

• Physician Affiliate Group of New York PC

  • Registered Dietitian
  • New York, NY
  • NPI 1013375526
  Medicare reassignment Care Compare group NPD
• Coney Island Medical Practice Plan, P.C.

  • General Practice Physician
  • Brooklyn, NY
  • NPI 1386951762
  Medicare reassignment NPD
• Island Internist PC

  • General Practice Physician
  • Staten Island, NY
  • NPI 1073669479
  Medicare reassignment NPD
• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)
• Nsuh South Beach Physicians Ufp Corporation

  • Geriatric Medicine (Internal Medicine) Physician
  • Staten Island, NY
  • NPI 1891682407
  NPD (past)
• Staten Island Care Center

  • Skilled Nursing Facility
  • Staten Island, NY
  • NPI 1447248273
  NPD (past)
• Secaucus Healthcare Center LLC

  • Skilled Nursing Facility
  • Secaucus, NJ
  • NPI 1457496721
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1124032982
  Care Compare affiliation

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275004800000",
    "number": "1861448896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 E 19TH ST",
            "address_2": "APT. 6 M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305457",
            "telephone_number": "718-338-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LYNDALE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126131",
            "telephone_number": "718-967-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALISOVA",
        "first_name": "LARISA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2010-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "234484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amie A. Malihan, M.D.
• Mayra Z. Malik, MD
• Neeraj Malik, PHARM.D.
• Rohail Malik, MD
• Nancy Luchavez Malinao, O.T.
• Alaina D Malizia
• Robert W Malizia, MD
• Liubov Malkova
• Andrea D. Maller, OD
• Sandra A Mallette, RN

• General Practice Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; 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.