Individual provider Active NPI

Moisey Iskhakov, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1972934354
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017197-1 Issued in NY
Practice address
550 First Avenue Cardiac Cath Lab
New York, NY 10016
Phone
(212) 263-5656
NPI assigned
Dec 10, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017197-1 NY Primary

Addresses

Primary practice location

550 First Avenue Cardiac Cath Lab
New York, NY 10016

Mailing address

657 Lander Dr
Highland Heights, OH 44143-2040
Phone (440) 382-6608

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address miskhakov85293@nyumc.direct-ci.com

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191029001707 NY Practitioner - Physician Assistant 7416289251 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017197-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Sep 14, 2019 Accepting new patients
New York University CurrentSince Sep 14, 2019 Accepting new patients

Locations

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

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Organizations & group practices 2

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": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1972934354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 LANDER DR",
            "city": "HIGHLAND HEIGHTS",
            "state": "OH",
            "postal_code": "441432040",
            "telephone_number": "440-382-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 FIRST AVENUE CARDIAC CATH LAB",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-263-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISKHAKOV",
        "first_name": "MOISEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-10",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017197-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "miskhakov85293@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "550 FIRST AVENUE CARDIAC CATH LAB",
            "city": "NEW YORK",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.