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LARISA MALISOVA DO
NPI 1861448896
General Practice in Staten Island, NY

Active since May 25, 2006PECOS EnrolledAccepts Medicare Assignment
420 LYNDALE AVE, STATEN ISLAND, NY 10312(718) 967-5630 Get Directions Write a Review

NPPES record last updated: May 28, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Larisa Malisova Do NPPES

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

LARISA MALISOVA DO (NPI 1861448896) is an individual general practice provider in Staten Island, New York, licensed in New York (234484) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with South Brooklyn Health, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2002).

NPPES Registry Identity

NPI1861448896
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameLARISA MALISOVACredential: DO
Location Address420 LYNDALE AVEStaten Island, NY 10312-6131
Mailing Address1270 E 19th St, Apt. 6 MBrooklyn, NY 11230-5457 · (718) 338-0164
Phone(718) 967-5630
Sole ProprietorYes
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2002
Enumeration DateMay 25, 2006
Last NPPES UpdateMay 28, 2010
✔ NPI 1861448896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in NY · 234484
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
420 LYNDALE AVE, Staten Island, NY 10312
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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

Larisa Malisova Do 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.

PECOS PAC ID4284637182
PECOS Enrollment IDI20060815000188
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Larisa Malisova reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Island Internist PC
Same address
General Practice
420 LYNDALE AVE
Staten Island, NY 10312
  • Reassigned Medicare billing, New York enrollment
  • 2 clinicians in this Medicare group
NPI 1073669479 (718) 967-5630
Coney Island Medical Practice Plan, P.C.
11 mi
General Practice
2601 OCEAN PKWY
Brooklyn, NY 11235
  • Reassigned Medicare billing, New York enrollment
  • 638 clinicians in this Medicare group
NPI 1386951762 (718) 616-5354
Physician Affiliate Group Of New York PC
22 mi
Dietitian, Registered
506 LENOX AVE
New York, NY 10037
  • Reassigned Medicare billing, New York enrollment
  • 2,094 clinicians in this Medicare group
NPI 1013375526 (212) 939-2467

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 10

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
146 services70 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
120 services30 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
72 services59 patients
Annual alcohol misuse screening, 5 to 15 minutes G0442
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
58 services58 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
49 services49 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
44 services44 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

South Brooklyn Health

Acute Care Hospitals · Brooklyn, NY
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number330196
Location2601 Ocean ParkwayBrooklyn, NY 11235 · Kings County
Emergency services Birthing friendly

Medicare 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.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%205 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
17 suppliers31 claims71 services$6.13 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
14 suppliers29 claims34 services$0.94 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

ISLAND INTERNIST PC
General Practice
420 LYNDALE AVE
STATEN ISLAND, NY 10312
Richmond County (718) 967-5630
DR. DONNA P SEMINARA MD
Internal Medicine (Geriatric Medicine)
420 LYNDALE AVE
STATEN ISLAND, NY 10312
Richmond County (718) 967-5630
DAVID R. PFAFF M.D.
Internal Medicine
420 LYNDALE AVE
STATEN ISLAND, NY 10312
Richmond County (718) 667-6776
NSUH SOUTH BEACH PHYSICIANS UFP CORPORATION
Internal Medicine (Geriatric Medicine)
420 LYNDALE AVE
STATEN ISLAND, NY 10312
Richmond County (718) 967-5630

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 Larisa Malisova's NPI number?

The NPI number for Larisa Malisova is 1861448896. It was assigned to this individual provider in the NPPES registry on May 25, 2006.

Where is Larisa Malisova located?

Larisa Malisova practices at 420 Lyndale Ave, Staten Island, NY 10312. The listed phone number is (718) 967-5630.

What is Larisa Malisova's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Larisa Malisova enrolled in Medicare?

Yes. Larisa Malisova 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 Larisa Malisova's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Larisa Malisova reassigns Medicare benefits to 3 organizations: Island Internist PC (Staten Island, NY), Coney Island Medical Practice Plan, P.C. (Brooklyn, NY) and Physician Affiliate Group Of New York PC (New York, NY). 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 Larisa Malisova's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Larisa Malisova affiliated with any hospitals?

According to CMS data, Larisa Malisova is affiliated with South Brooklyn Health.

When was this NPI record last updated?

The NPPES record for Larisa Malisova was last updated on May 28, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.