ITAMAR NIESVIZKY-KOGAN MD
NPI 1043709348
Student in an Organized Health Care Education/Training Program in Syracuse, NY

Q: What is Itamar Niesvizky-kogan's NPI number?

The NPI number for Itamar Niesvizky-kogan is 1043709348. It was assigned to this individual provider in the NPPES registry on May 2, 2018.

Q: What is Itamar Niesvizky-kogan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since May 02, 2018PECOS EnrolledAccepts Medicare Assignment

750 E ADAMS ST, SYRACUSE, NY 13210(315) 464-4570 Get Directions Write a Review

NPPES record last updated: May 2, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Itamar Niesvizky-kogan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ITAMAR NIESVIZKY-KOGAN MD (NPI 1043709348) is an individual student in an organized health care education/training program in Syracuse, New York and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS, is affiliated with North Shore University Hospital, and is a graduate of State University Of Ny Upstate Medical University (2018).

NPPES Registry Identity

NPI1043709348

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameITAMAR NIESVIZKY-KOGANCredential: MD

Location Address750 E ADAMS STSyracuse, NY 13210-1834

Mailing Address60 Presidential Plz Apt 617Syracuse, NY 13202-2216

Phone(315) 464-4570

Sole ProprietorYes

Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2018

Enumeration DateMay 2, 2018

✔ NPI 1043709348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

750 E ADAMS ST, Syracuse, NY 13210

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Itamar Niesvizky-kogan Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648517284

PECOS Enrollment IDI20251021002414

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Shore University Hospital

Acute Care Hospitals · Manhasset, NY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330106

Location300 Community DriveManhasset, NY 11030 · Nassau County

Emergency services Birthing friendly

Northwell Hospital Glen Cove

Acute Care Hospitals · Glen Cove, NY

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330181

Location101 St Andrews LaneGlen Cove, NY 11542 · Nassau County

Emergency services

Long Island Jewish Medical Center

Acute Care Hospitals · New Hyde Park, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330195

Location270 - 05 76th AvenueNew Hyde Park, NY 11040 · Nassau County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID M KANTER MD

Physical Medicine & Rehabilitation