ST. NICHOLAS PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC
NPI 1033631064
Surgery - Vascular Surgery in New York, NY
About St. Nicholas Professional Medical Services Of New York Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ST. NICHOLAS PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC (NPI 1033631064) is a healthcare organization registered as a vascular surgery in New York, New York and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through August 4, 2028 and lists Flora Katsnelson, Owner/director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
St. Nicholas Professional Medical Services Of New York Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
28Medicare enrollment records show 28 clinicians reassign Medicare billing to St. Nicholas Professional Medical Services Of New York LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 9 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 10
Nearest to this location (20)
See all 28Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 33D2157745
St Nicholas Professional Medical Services Of New York LLC · New York, NYFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is St. Nicholas Professional Medical Services Of New York LLC's NPI number?
The NPI number for St. Nicholas Professional Medical Services Of New York LLC is 1033631064. It was assigned to this organization in the NPPES registry on July 11, 2017.
Where is St. Nicholas Professional Medical Services Of New York LLC located?
St. Nicholas Professional Medical Services Of New York LLC is located at 1264 Saint Nicholas Ave Ste A, New York, NY 10033. The listed phone number is (718) 301-1100.
What is St. Nicholas Professional Medical Services Of New York LLC's specialty?
The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.
Is St. Nicholas Professional Medical Services Of New York LLC enrolled in Medicare?
Yes. St. Nicholas Professional Medical Services Of New York LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through St. Nicholas Professional Medical Services Of New York LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 28 clinicians in 10 Medicare specialties reassign their Medicare billing to St. Nicholas Professional Medical Services Of New York LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Interventional Radiology (6), General Surgery (5) and Vascular Surgery (5). Of these, 1 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does St. Nicholas Professional Medical Services Of New York LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D2157745) is associated with this NPI, valid through August 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for St. Nicholas Professional Medical Services Of New York LLC was last updated on July 11, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# St. Nicholas Professional Medical Services Of New York Llc · NPI 1033631064
Vascular Surgery organization in New York, New York. Organization record, active in the CMS NPPES registry since July 11, 2017.
## Identity
- **NPI:** 1033631064 (Entity type: Organization)
- **Enumerated:** July 11, 2017
- **Primary specialty:** Surgery - Vascular Surgery · taxonomy 2086S0129X
- **Organization subpart:** No
- **Authorized official:** Flora Katsnelson, OWNER/DIRECTOR
## Practice location
- **Address:** 1264 SAINT NICHOLAS AVE STE A, New York, NY 10033-7263
- **Phone:** (718) 301-1100 · **Fax:** (224) 246-8042
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 28 clinicians in 10 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Interventional Radiology (6), General Surgery (5), Vascular Surgery (5); 1 practice at this address and 9 within 10 miles; [full list](https://npiprofile.com/npi/1033631064/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 11, 2017
- **Other identifiers:** Medicaid 036113246 (IL)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1033631064) · Data from the CMS NPPES public registry.