Tatyana Nisimova

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

092193 Issued in NY

Practice address

450 7TH Ave Ste 809
New York, NY 10123-0805

Phone

(718) 260-6042

NPI assigned

Mar 12, 2014

Sex

Female

Sole proprietor

Yes

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tatyana.nisimova.1@24284.direct.athenahealth.com
• FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

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.

• Bleuler Psychotherapy Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Forest Hills, NY
  • NPI 1801949706
  Medicare reassignment NPD

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1871919084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 7TH AVE STE 809",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101230805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 7TH AVE STE 809",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101230805",
            "telephone_number": "718-260-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISIMOVA",
        "first_name": "TATYANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-12",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092193",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "101260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makoto Nishimura, MD
• Masayo Nishimura, LAC, LMT
• Yukina Cindy Nishio
• Ava Tamiko Nishita-Hawkinson, LMSW
• Emmanuel Nisimov, M.D.
• Noora Johanna Niskanen, LCSW
• Barton Nisonson, MD
• Gabriella Nissan, PSY.D.
• Noam Nissan
• Atara Nissel, PA

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.