Active NPI
Ross John Mishkin, LMHC, M.S.ED.
- Mental Health Counselor
- Wading River, NY
National Provider Identifier
1972267573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 008285
- Practice address
- 56 Broad View Cir
Wading River, NY 11792-1000 - Phone
- (631) 903-7355
- NPI assigned
- Oct 29, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 008285 | NY | Primary |
Addresses
Primary practice location
56 Broad View Cir
Wading River, NY 11792-1000
Mailing address
56 Broad View Cir
Wading River, NY 11792-1000
Phone (631) 903-7355
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240130002977 | NY | Practitioner - Mental Health Counselor | 8426401076 | Practice locations: Wading River, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008285 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635465600000",
"number": "1972267573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 BROAD VIEW CIR",
"city": "WADING RIVER",
"state": "NY",
"postal_code": "117921000",
"telephone_number": "631-903-7355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 BROAD VIEW CIR",
"city": "WADING RIVER",
"state": "NY",
"postal_code": "117921000",
"telephone_number": "631-903-7355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISHKIN",
"first_name": "ROSS",
"middle_name": "JOHN",
"credential": "LMHC, M.S.ED.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-10-29",
"last_updated": "2021-10-29",
"certification_date": "2021-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "008285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wading River, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.