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KEVIN MISHAN DO
NPI 1306595111
Emergency Medicine in Worcester, MA

Active since March 20, 2022PECOS Enrolled
55 LAKE AVE N, WORCESTER, MA 01655(508) 334-1000 Get Directions Write a Review

NPPES record last updated: April 24, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 24, 2026, Jul 25, 2022 (2 updates tracked since 2022).

About Kevin Mishan Do NPPES

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

KEVIN MISHAN DO (NPI 1306595111) is an individual emergency medicine provider in Worcester, Massachusetts, licensed in Massachusetts (1026042) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in Bronx, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2022).

NPPES Registry Identity

NPI1306595111
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameKEVIN MISHANCredential: DO
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing Address281 Lincoln St, Provider Enrollment DepartmentWorcester, MA 01605-2138 · (508) 334-8015 · Fax (508) 334-8105
Phone(508) 334-1000
Sole ProprietorYes
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2022
Enumeration DateMarch 20, 2022
Last NPPES UpdateApril 24, 20262 updates tracked since enumeration
NPPES CertifiedApril 24, 2026
✔ NPI 1306595111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in MA · 1026042
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
55 LAKE AVE N, Worcester, MA 01655
Open in Google Maps ↗

Secondary Practice Location 1

Location 14422 3rd AveBronx, NY 10457-2594 · Phone (718) 960-6240

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Mishan Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1052889623
PECOS Enrollment IDI20260501003079
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01655 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
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.

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.

HILLARY R. IRONS MD
Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 421-1400
MS. EILEEN A. DUHAMEL NP
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-2710
EWA HRYNISZYN CRNA
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
HELEN COPSEY PA-C
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-8585
DR. ADEPEJU GBADEBO CHAMPION M.D.
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-2731
SOWMYA KORAPATI
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-3550
LAYLA FAKHRZADEH M.D.
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
YOONYIE CHO M.D.
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-1000

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 Kevin Mishan's NPI number?

The NPI number for Kevin Mishan is 1306595111. It was assigned to this individual provider in the NPPES registry on March 20, 2022.

Where is Kevin Mishan located?

Kevin Mishan practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 334-1000.

What is Kevin Mishan's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Kevin Mishan enrolled in Medicare?

Yes. Kevin Mishan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Mishan was last updated on April 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.