DR. MICHAEL TYSHKOV MD
NPI 1902882038
Pediatrics - Pediatric Gastroenterology in Staten Island, NY

Q: What is Michael Tyshkov's NPI number?

The NPI number for Michael Tyshkov is 1902882038. It was assigned to this individual provider in the NPPES registry on December 20, 2005.

Q: What is Michael Tyshkov's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

Q: When was this NPI record last updated?

The NPPES record for Michael Tyshkov was last updated on December 31, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.

Active since December 20, 2005

584 FOREST AVE, STATEN ISLAND, NY 10310(718) 226-5619(718) 226-5620 Get Directions Write a Review

NPPES record last updated: December 31, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Michael Tyshkov Md NPPES

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

DR. MICHAEL TYSHKOV MD (NPI 1902882038) is an individual pediatric gastroenterology provider in Staten Island, New York, licensed in New York (180877) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1902882038

Entity TypeIndividualMale

Primary Taxonomy2080P0206X

Provider Legal NameDR. MICHAEL TYSHKOVCredential: MD

Location Address584 FOREST AVEStaten Island, NY 10310-2512

Mailing Address1 Edgewater St, 6th Fl. Payer RelationsStaten Island, NY 10305-4900 · (718) 226-1008 · Fax (718) 226-1039

Phone(718) 226-5619

Fax(718) 226-5620

Sole ProprietorNo

Enumeration DateDecember 20, 2005

Last NPPES UpdateDecember 31, 2008

✔ NPI 1902882038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0206X

License✔ Licensed in NY · 180877

Definition

A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

584 FOREST AVE, Staten Island, NY 10310

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Other Identifiers 5

Medicare PIN555221NY

Medicare PIN195247NJ

Medicaid01268262NY

Medicare UPINE94818NY

Medicaid5341400NJ

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EUGENE HOLUKA MD

Internal Medicine