Individual provider Active NPI

Emmanuel Nisimov, M.D.

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1942694120
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
290588 Issued in NY
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(212) 263-7000
NPI assigned
Mar 25, 2015
Last updated
Apr 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 290588 NY Primary

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

550 1St Ave
New York, NY 10016-6402

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190715002994 NY Practitioner - Anesthesiology 6406148147 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of Ny Upstate Medical University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sedation Vacation Perioperative Medicine PLLCGroup PAC ID 1759658594, 86 clinicians
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

10512 101St Ave
Ozone Park, NY 11416-2703
Phone (718) 847-3700

1396 Myrtle Ave
Brooklyn, NY 11237-4513
Phone (718) 222-5999

530 1St Ave
New York, NY 10016-6402

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-6037

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Feb 1, 2023 Accepting new patients
Centurion Brooklyn Anesthesia PLLC CurrentSince Sep 28, 2024 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Jul 2, 2019 Accepting new patients
Centurion Midtown Anesthesia PLLC Anesthesiology CurrentSince Feb 15, 2025 Accepting new patients
New York University Anesthesiology Current Accepting new patients
Sedation Vacation Perioperative Medicine PLLC CurrentSince Jan 1, 2022 Accepting new patients
New York University Anesthesiology CurrentSince Feb 1, 2023 Accepting new patients

Locations

1396 Myrtle Ave
Brooklyn, NY 11237
Phone (718) 878-4313

1630 E 14th St
Brooklyn, NY 11229
Phone (516) 612-3722

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

11129 Queens Blvd
Forest Hills, NY 11375
Phone (718) 275-8900

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

305 E 47th St
New York, NY 10017
Phone (212) 203-8744

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

10512 101st Ave
Ozone Park, NY 11416
Phone (718) 847-3600

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1942694120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISIMOV",
        "first_name": "EMMANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "290588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.