TIMUR PETRISHIN PC
NPI 1801521018
Counselor - Professional in Fort Lee, NJ
About Timur Petrishin Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIMUR PETRISHIN PC (NPI 1801521018) is an individual professional provider in Fort Lee, New Jersey, licensed in New Jersey (37PC00825100) and active in the NPI registry since July 2022. He has opted out of Medicare through April 7, 2028.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Timur Petrishin Pc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 7, 2026 through April 7, 2028.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT LEE, NJ 07024
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 Timur Petrishin's NPI number?
The NPI number for Timur Petrishin is 1801521018. It was assigned to this individual provider in the NPPES registry on July 21, 2022.
Where is Timur Petrishin located?
Timur Petrishin practices at 2185 Lemoine Ave Ste 1G, Fort Lee, NJ 07024. The listed phone number is (877) 959-8180.
What is Timur Petrishin's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Timur Petrishin enrolled in Medicare?
No. Timur Petrishin has opted out of Medicare through April 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Timur Petrishin was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Timur Petrishin, PC · NPI 1801521018
Professional provider in Fort Lee, New Jersey. Individual provider, active in the CMS NPPES registry since July 21, 2022.
## Identity
- **NPI:** 1801521018 (Entity type: Individual)
- **Enumerated:** July 21, 2022
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 37PC00825100 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 2185 LEMOINE AVE STE 1G, Fort Lee, NJ 07024-6030
- **Phone:** (877) 959-8180 · **Fax:** (866) 535-3188
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through April 7, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** July 21, 2022
- **Other identifiers:** Other 37PC00825100 (NJ)
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Source: [NPI Profile](https://npiprofile.com/npi/1801521018) · Data from the CMS NPPES public registry.