Individual provider Active NPI

Kalliope Tsirilakis, M.D.

  • Pediatric Pulmonology Physician
  • Great Neck, NY
National Provider Identifier
1962723312
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
239793 Issued in NY
Practice address
865 Northern Blvd
Suite 103
Great Neck, NY 11021-5335
Phone
(516) 622-5280
NPI assigned
Jun 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 239793 NY Primary

Addresses

Primary practice location

865 Northern Blvd
Suite 103
Great Neck, NY 11021-5335

Mailing address

865 Northern Blvd
Suite 103
Great Neck, NY 11021-5335
Phone (516) 622-5280

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address kat2001@direct.nyp.org Direct

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
I20101130000592 NY Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 2668668823 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
239793NYMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Dec 11, 2018 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Oct 7, 2018 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Oct 7, 2018 Accepting new patients
Weill Medical College of Cornell CurrentSince Dec 11, 2018 Accepting new patients

Locations

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

525 E 68th St
#M6
New York, NY 10065
Phone (212) 746-3558

505 E 70th St
Fl 2
New York, NY 10021
Phone (212) 746-1578

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Networks

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

Interoperability endpoints

  • Direct secure messaging: kat2001@direct.nyp.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1962723312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 NORTHERN BLVD",
            "address_2": "SUITE 103",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215335",
            "telephone_number": "516-622-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 NORTHERN BLVD",
            "address_2": "SUITE 103",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215335",
            "telephone_number": "516-622-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIRILAKIS",
        "first_name": "KALLIOPE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "239793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St",
            "address_2": "Pediatric Asthma Center",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "5645 Main St",
            "address_2": "Pediatric Asthma Center",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kat2001@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "5645 Main St",
            "address_2": "Pediatric Asthma Center",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.