ADVANCED ADULT HEALTH NP, PC.
NPI 1174804454
Nurse Practitioner - Adult Health in Bronx, NY
About Advanced Adult Health Np, Pc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ADVANCED ADULT HEALTH NP, PC. (NPI 1174804454) is a healthcare organization registered as an adult health in Bronx, New York and active in the NPI registry since August 2011. The organization lists Erik P Mordukhayev, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Advanced Adult Health Np, Pc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Advanced Adult Health Np, PC., which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Advanced Adult Health Np, PC.'s NPI number?
The NPI number for Advanced Adult Health Np, PC. is 1174804454. It was assigned to this organization in the NPPES registry on August 31, 2011.
Where is Advanced Adult Health Np, PC. located?
Advanced Adult Health Np, PC. is located at 2109 Matthews Ave, Bronx, NY 10462. The listed phone number is (718) 794-1000.
What is Advanced Adult Health Np, PC.'s specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Advanced Adult Health Np, PC. enrolled in Medicare?
Yes. Advanced Adult Health Np, PC. is registered in the Medicare PECOS enrollment system.
When is Advanced Adult Health Np, PC.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Advanced Adult Health Np, PC.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Advanced Adult Health Np, PC.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Advanced Adult Health Np, PC. was last updated on September 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Advanced Adult Health Np, Pc. · NPI 1174804454
Adult Health organization in Bronx, New York. Organization record, active in the CMS NPPES registry since August 31, 2011.
## Identity
- **NPI:** 1174804454 (Entity type: Organization)
- **Enumerated:** August 31, 2011
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **Organization subpart:** No
- **Authorized official:** Erik Mordukhayev, PRESIDENT
## Practice location
- **Address:** 2109 MATTHEWS AVE, Bronx, NY 10462-2614
- **Phone:** (718) 794-1000 · **Fax:** (718) 794-5264
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 2, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1174804454) · Data from the CMS NPPES public registry.