ST. NICHOLAS MEDICAL PC
NPI 1912192394
Specialist in Brooklyn, NY

Active since September 10, 2007
115 SAINT NICHOLAS AVE, BROOKLYN, NY 11237(718) 418-8368(718) 418-8716 Get Directions Write a Review

NPPES record last updated: October 9, 2008. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About St. Nicholas Medical Pc NPPES

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

ST. NICHOLAS MEDICAL PC (NPI 1912192394) is a healthcare organization registered as a specialist in Brooklyn, New York and active in the NPI registry since September 2007. The organization lists Myat San, President, as its authorized official.

NPPES Registry Identity

NPI1912192394
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameST. NICHOLAS MEDICAL PC
Location Address115 SAINT NICHOLAS AVEBrooklyn, NY 11237-3474
Mailing Address115 Saint Nicholas AveBrooklyn, NY 11237-3474 · (718) 418-8368 · Fax (718) 418-8716
Fax(718) 418-8716
Organization SubpartNo
Authorized OfficialMyat SanPresident · (718) 418-8368
Enumeration DateSeptember 10, 2007
Last NPPES UpdateOctober 9, 2008
✔ NPI 1912192394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 231830
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
115 SAINT NICHOLAS AVE, Brooklyn, NY 11237

Other Identifiers 6

Medicare PIN109938NY
Medicare PIN08223HNY
Medicare PIN08223GNY
Medicare PINW87261NY
Medicare PIN45C518NY
Medicaid01925768NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

St. Nicholas Medical Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to St. Nicholas Medical PC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians, nearest first (9)

Internal Medicine
NPI 1902269616
115 SAINT NICHOLAS AVE
Brooklyn, NY 11237
(718) 418-8368
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1366183683
115 SAINT NICHOLAS AVE
Brooklyn, NY 11237
(718) 418-8368
✔ PECOSSame address
Internal Medicine
NPI 1114344017
115 SAINT NICHOLAS AVE
Brooklyn, NY 11237
(718) 418-8368
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1134284581
115 SAINT NICHOLAS AVE APT # 1
Brooklyn, NY 11237
(718) 418-8368
✔ PECOS✔ Accepts MedicareSame address
Cardiovascular Disease (Cardiology)
NPI 1871565242
3180 41ST ST
Astoria, NY 11103
(718) 278-5100
✔ PECOS✔ Accepts Medicare3.7 mi
Internal Medicine
NPI 1992723753
4904 19TH AVE
Astoria, NY 11105
(718) 546-5200
✔ PECOS8.5 mi
Internal Medicine
NPI 1881824829
4904 19TH AVE
Astoria, NY 11105
(718) 777-3494
✔ PECOS✔ Accepts Medicare8.5 mi
Internal Medicine
NPI 1023325016
6900 N PECOS RD
North Las Vegas, NV 89086
(702) 791-9000
✔ PECOS2,232 mi
Internal Medicine
NPI 1447675566
1225 OAKDALE RD
Modesto, CA 95355
(209) 557-6200
✔ PECOS2,504 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 St. Nicholas Medical PC's NPI number?

The NPI number for St. Nicholas Medical PC is 1912192394. It was assigned to this organization in the NPPES registry on September 10, 2007.

Where is St. Nicholas Medical PC located?

St. Nicholas Medical PC is located at 115 Saint Nicholas Ave, Brooklyn, NY 11237. The listed phone number is (718) 418-8368.

What is St. Nicholas Medical PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is St. Nicholas Medical PC enrolled in Medicare?

Yes. St. Nicholas Medical PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through St. Nicholas Medical PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 2 Medicare specialties reassign their Medicare billing to St. Nicholas Medical PC. A 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 the clinician's services. The largest specialties are Internal Medicine (8) and Cardiovascular Disease (Cardiology) (1). Of these, 4 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for St. Nicholas Medical PC was last updated on October 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.