Individual provider Active NPI

Lydia V Grishin, M.D.

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1972559425
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
223066 Issued in NY
Practice address
1365 York Ave
Suite 19F
New York, NY 10021-4035
Phone
(917) 415-8420
Fax
(704) 296-2305
NPI assigned
May 26, 2006
Last updated
Feb 6, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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 223066 NY Primary

Addresses

Primary practice location

1365 York Ave
Suite 19F
New York, NY 10021-4035

Mailing address

1365 York Ave
Suite 19F
New York, NY 10021-4035
Phone (917) 415-8420

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
I20070430000674 NY Practitioner - Anesthesiology 2860598307 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1984
Medicare assignment
May accept Medicare assignment
Group practices
Joel Bruce Fieldman MD PCGroup PAC ID 1951553411, 2 clinicians

Practice addresses (Care Compare)

11204 Queens Blvd
Forest Hills, NY 11375-6344
Phone (718) 263-6083

210 E Sunrise Hwy
Valley Stream, NY 11581-1329
Phone (718) 657-2789

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223066NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joel Bruce Fieldman MD P.C. Anesthesiology CurrentSince Jan 1, 2016 Accepting new patients
Queens Endoscopy ASC, LLC CurrentSince Jun 1, 2015 Accepting new patients
Comfort Anesthesia PC Anesthesiology Past Accepting new patients

Locations

11204 Queens Blvd
Forest Hills, NY 11375
Phone (718) 263-6083

17660 Union Tpke
Fresh Meadows, NY 11366
Phone (212) 774-2474

18904 Union Tpke
Fresh Meadows, NY 11366
Phone (718) 217-1414

20 W Lincoln Ave
Ste 201
Valley Stream, NY 11580
Phone (516) 872-3885

210 E Sunrise Hwy
Valley Stream, NY 11581
Phone (516) 825-8484

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1972559425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 YORK AVE",
            "address_2": "SUITE 19F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214035",
            "telephone_number": "917-415-8420",
            "fax_number": "704-296-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 YORK AVE",
            "address_2": "SUITE 19F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214035",
            "telephone_number": "917-415-8420",
            "fax_number": "704-296-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHIN",
        "first_name": "LYDIA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "223066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.