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DOCTOR HANY G NISSIEM FAMILY MEDICINE PLLC
NPI 1184670283
Family Medicine in Brockport, NY

Active since May 26, 2006
6565 FOURTH SECTION RD, SUITE 300, BROCKPORT, NY 14420(585) 395-0620(585) 395-0622 Get Directions Write a Review

NPPES record last updated: August 3, 2017. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 3, 2017, Oct 26, 2016 (2 updates tracked since 2016).

About Doctor Hany G Nissiem Family Medicine Pllc NPPES

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

DOCTOR HANY G NISSIEM FAMILY MEDICINE PLLC (NPI 1184670283) is a healthcare organization registered as a family medicine in Brockport, New York and active in the NPI registry since May 2006. The organization lists Hany Nissiem, Owner, as its authorized official.

NPPES Registry Identity

NPI1184670283
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDOCTOR HANY G NISSIEM FAMILY MEDICINE PLLC
Location Address6565 FOURTH SECTION RD, SUITE 300Brockport, NY 14420-2414
Mailing Address6565 Fouth Section Rd, Suite 300Brockport, NY 14420-2416 · (585) 395-0620 · Fax (585) 395-0622
Phone(585) 395-0620
Fax(585) 395-0622
Organization SubpartNo
Authorized OfficialHany NissiemOwner · (585) 395-0620
Enumeration DateMay 26, 2006
Last NPPES UpdateAugust 3, 20172 updates tracked since enumeration
✔ NPI 1184670283 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 227675
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
6565 FOURTH SECTION RD, Brockport, NY 14420
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Other Identifiers 1

Medicare ID-Type UnspecifiedBA0553

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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)

Doctor Hany G Nissiem Family Medicine Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

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.

StateEnrollment IDDue date
StateNew YorkEnrollment IDO20050527000253Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Doctor Hany G Nissiem Family Medicine PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Hany Nissiem, M.D
Family Practice
NPI 1295782399
6565 FOURTH SECTION RD SUITE 300
Brockport, NY 14420
(585) 395-0620
✔ PECOS✔ Accepts MedicareSame address

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 Doctor Hany G Nissiem Family Medicine PLLC's NPI number?

The NPI number for Doctor Hany G Nissiem Family Medicine PLLC is 1184670283. It was assigned to this organization in the NPPES registry on May 26, 2006.

Where is Doctor Hany G Nissiem Family Medicine PLLC located?

Doctor Hany G Nissiem Family Medicine PLLC is located at 6565 Fourth Section Rd Suite 300, Brockport, NY 14420. The listed phone number is (585) 395-0620.

What is Doctor Hany G Nissiem Family Medicine PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Doctor Hany G Nissiem Family Medicine PLLC enrolled in Medicare?

Yes. Doctor Hany G Nissiem Family Medicine PLLC is registered in the Medicare PECOS enrollment system.

When is Doctor Hany G Nissiem Family Medicine PLLC'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 January 31, 2027. 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 Doctor Hany G Nissiem Family Medicine PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Doctor Hany G Nissiem Family Medicine PLLC. 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 Doctor Hany G Nissiem Family Medicine PLLC was last updated on August 3, 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.