DR. DMITRY LISENENKOV M.D.
NPI 1679736953
Anesthesiology - Critical Care Medicine in Staten Island, NY
About Dr. Dmitry Lisenenkov M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DMITRY LISENENKOV M.D. (NPI 1679736953) is an individual critical care medicine provider in Staten Island, New York, licensed in New Jersey (25MA11111600) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Newark Beth Israel Medical Center, and is a graduate of Other (2005).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Dmitry Lisenenkov M.d. 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.
Medicare Billing Reassignments
10Medicare enrollment records show Dmitry Lisenenkov reassigns Medicare billing to 10 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Brooklyn, NY 11219
- Reassigned Medicare billing, New York enrollment
- 23 clinicians in this Medicare group
Brooklyn, NY 11219
- Reassigned Medicare billing, New York enrollment
- 1,177 clinicians in this Medicare group
Staten Island, NY 10312
- Reassigned Medicare billing, New York enrollment
- 530 clinicians in this Medicare group
Elizabeth, NJ 07202
- Reassigned Medicare billing, New Jersey enrollment
- 1,894 clinicians in this Medicare group
New York, NY 10025
- Reassigned Medicare billing, New York enrollment
- 5,251 clinicians in this Medicare group
Inwood, NY 11096
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Nassau Health Care Corporation
- 553 clinicians in this Medicare group
Passaic, NJ 07055
- Reassigned Medicare billing, New Jersey enrollment
- 51 clinicians in this Medicare group
New Hyde Park, NY 11040
- Reassigned Medicare billing, New York enrollment
- 9,353 clinicians in this Medicare group
West Islip, NY 11795
- Reassigned Medicare billing, New York enrollment
- 395 clinicians in this Medicare group
Turnersville, NJ 08012
- Reassigned Medicare billing, New Jersey enrollment
- 32 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Newark Beth Israel Medical Center
Acute Care Hospitals · Newark, NJRaritan Bay Medical Center
Acute Care Hospitals · Perth Amboy, NJMedicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
STATEN ISLAND, NY 10305
STATEN ISLAND, NY 10305
STATEN ISLAND, NY 10305
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 Dmitry Lisenenkov's NPI number?
The NPI number for Dmitry Lisenenkov is 1679736953. It was assigned to this individual provider in the NPPES registry on July 7, 2008.
Where is Dmitry Lisenenkov located?
Dmitry Lisenenkov practices at 475 Seaview Ave Cardiothoracic Icu, Staten Island, NY 10305. The listed phone number is (718) 775-7770.
What is Dmitry Lisenenkov's specialty?
The primary specialty registered for this NPI is Anesthesiology, specializing in Critical Care Medicine, with taxonomy code 207LC0200X.
Is Dmitry Lisenenkov enrolled in Medicare?
Yes. Dmitry Lisenenkov is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Dmitry Lisenenkov's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dmitry Lisenenkov reassigns Medicare benefits to 10 organizations: Maimonides Medical Center - Maimo Criticare Fpp (Brooklyn, NY), Maimonides Faculty Practice Plan (Brooklyn, NY), Physicians Of University Hospital PC (Staten Island, NY), Barnabas Health Medical Group PC (Elizabeth, NJ), Montefiore Medical Center (New York, NY) and 5 more organizations, listed in the Medicare section above. Each 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 Dmitry Lisenenkov's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Dmitry Lisenenkov accept?
Health plans from Blue Cross and Blue Shield of Texas and Oscar Health Maintenance Organization of Florida list Dmitry Lisenenkov as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Dmitry Lisenenkov affiliated with any hospitals?
According to CMS data, Dmitry Lisenenkov is affiliated with Newark Beth Israel Medical Center and Raritan Bay Medical Center.
When was this NPI record last updated?
The NPPES record for Dmitry Lisenenkov was last updated on May 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Dr. Dmitry Lisenenkov, M.D. · NPI 1679736953
Critical Care Medicine physician in Staten Island, New York. Individual provider, active in the CMS NPPES registry since July 7, 2008.
## Identity
- **NPI:** 1679736953 (Entity type: Individual)
- **Enumerated:** July 7, 2008
- **Primary specialty:** Anesthesiology - Critical Care Medicine · taxonomy 207LC0200X
- **State license:** 25MA11111600 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 475 SEAVIEW AVE, CARDIOTHORACIC ICU, Staten Island, NY 10305
- **Phone:** (718) 775-7770
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 10 organizations under Medicare reassignment (form CMS-855R): Maimonides Medical Center - Maimo Criticare Fpp (NPI 1265547178, Brooklyn, NY); Maimonides Faculty Practice Plan (NPI 1053344846, Brooklyn, NY); Physicians Of University Hospital PC (NPI 1013368224, Staten Island, NY); Barnabas Health Medical Group PC (NPI 1841557246, Elizabeth, NJ); Montefiore Medical Center (NPI 1760288278, New York, NY); and 5 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** May 2, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1679736953) · Data from the CMS NPPES public registry.