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AMIELA MORDUKHAYEV
NPI 1053279265
Nurse Practitioner - Family in Middle Village, NY

Active since January 14, 2026PECOS Enrolled
6366 79TH ST, MIDDLE VILLAGE, NY 11379(917) 655-1198 Get Directions Write a Review

NPPES record last updated: January 27, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 27, 2026, Jan 14, 2026 (2 updates tracked since 2026).

About Amiela Mordukhayev NPPES

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

AMIELA MORDUKHAYEV (NPI 1053279265) is an individual family provider in Middle Village, New York, licensed in New York (358757) and active in the NPI registry since January 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1053279265
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameAMIELA MORDUKHAYEV
Location Address6366 79TH STMiddle Village, NY 11379-1310
Mailing Address6366 79th StMiddle Village, NY 11379-1310
Phone(917) 655-1198
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJanuary 14, 2026
Last NPPES UpdateJanuary 27, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 27, 2026
✔ NPI 1053279265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 358757
6366 79TH ST, Middle Village, NY 11379
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amiela Mordukhayev is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4880165000
PECOS Enrollment IDI20260608003648
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.

Medicare Billing Reassignment

Medicare enrollment records show Amiela Mordukhayev reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Perry Ave Family Medical Center Inc
11 mi
Family Medicine
3071 PERRY AVE
Bronx, NY 10467
  • Reassigned Medicare billing, New York enrollment
  • 82 clinicians in this Medicare group
NPI 1619973518 (718) 231-6700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11379 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.17 typical visit price
range $67.00 – $201.98
Typical copayment $26.04 (range $16.75 – $50.49)
Most-billed visit code 99203
Established Patient
$116.96 typical visit price
range $21.62 – $163.52
Typical copayment $29.24 (range $5.40 – $40.88)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently 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 Amiela Mordukhayev's NPI number?

The NPI number for Amiela Mordukhayev is 1053279265. It was assigned to this individual provider in the NPPES registry on January 14, 2026.

Where is Amiela Mordukhayev located?

Amiela Mordukhayev practices at 6366 79th St, Middle Village, NY 11379. The listed phone number is (917) 655-1198.

What is Amiela Mordukhayev's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Amiela Mordukhayev enrolled in Medicare?

Yes. Amiela Mordukhayev is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Amiela Mordukhayev's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amiela Mordukhayev reassigns Medicare benefits to Perry Ave Family Medical Center Inc (Bronx, NY). The 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 Amiela Mordukhayev's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Amiela Mordukhayev was last updated on January 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.