Active NPI
Nikita Mishra
- Physician Assistant
- Glendale, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 19555 N 59TH Ave
Glendale, AZ 85308-6813 - Phone
- (623) 572-3200
- NPI assigned
- Sep 24, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
19555 N 59TH Ave
Glendale, AZ 85308-6813
Mailing address
19555 N 59TH Ave
Glendale, AZ 85308-6813
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1027 46TH Ave
Long Island City, NY 11101-5202
1027 46TH Ave
Long Island City, NY 11101-5245
220 Front St
New York, NY 10038-2031
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Derm Specs of PA PLLC | Current | Accepting new patients | |
| Bobby Buka, M.D., P.C. | Current | Accepting new patients | |
| Atlas Infectious Disease Practice PLLC | Past | Accepting new patients | |
| Mount Sinai Hospital | Past | Accepting new patients | |
| Out East Medical | Past | Accepting new patients |
Locations
3179 Steinway St
Astoria, NY 11103
1163 Myrtle Ave
Brooklyn, NY 11206
1027 46th Ave
Fl 1
Long Island City, NY 11101
625 10th Ave
New York, NY 10036
1425 2nd Ave
New York, NY 10021
214 Sullivan St
New York, NY 10012
2121 Adam Clayton Powell Jr Blvd
New York, NY 10027
Phone (718) 534-8190
3531 Long Beach Rd
Oceanside, NY 11572
Interoperability endpoints
- https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4
- https://fhir4.healow.com/fhir/r4/BFCDAA
Organizations & group practices 5
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.
-
- Dermatology Physician
- New York, NY
- NPI 1134349954
-
- Dermatology Physician
- Philadelphia, PA
- NPI 1528823507
-
- Infectious Disease Physician
- Atlantis, FL
- NPI 1326655846
-
- General Acute Care Hospital
- New York, NY
- NPI 1932103413
-
- Dermatology Physician
- Oceanside, NY
- NPI 1730757311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1902623671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19555 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19555 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086813",
"telephone_number": "623-572-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISHRA",
"first_name": "NIKITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-24",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.
- 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.