Samir Derisavifard, MD - Medicare Urology in Rego Park, NY

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Samir Derisavifard, MD is a medicare enrolled "Urology - Female Pelvic Medicine And Reconstructive Surgery" physician in Rego Park, New York. He graduated from medical school in 2013 and has 13 years of diverse experience with area of expertise as Urology. He is a member of the group practice North Shore Lij Medical Group At North Nassau, Pc and his current practice location is 9225 Queens Blvd Fl 2, Rego Park, New York. You can reach out to his office (for appointments etc.) via phone at (817) 925-6200.

Samir Derisavifard is licensed to practice in New York (license number 282292-01) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1477997690.

Contact Information

Samir Derisavifard, MD
9225 Queens Blvd Fl 2,
Rego Park, NY 11374
(817) 925-6200
Not Available

Map and Direction




Physician's Profile

Full NameSamir Derisavifard
GenderMale
SpecialityUrology
Experience13 Years
Location9225 Queens Blvd Fl 2, Rego Park, New York
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Samir Derisavifard graduated from medical school in 2013
  NPI Data:
  • NPI Number: 1477997690
  • Provider Enumeration Date: 04/18/2013
  • Last Update Date: 06/12/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8325302029
  • Enrollment ID: I20220915000925

Medical Identifiers

Medical identifiers for Samir Derisavifard such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1477997690NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208800000XUrology S5157 (Texas)Secondary
208800000XUrology 282292-01 (New York)Secondary
2088F0040XUrology - Female Pelvic Medicine And Reconstructive Surgery 282292-01 (New York)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Long Island Jewish Medical CenterNew hyde park, NYHospital
Northwell Hospital Glen CoveGlen cove, NYHospital
North Shore University HospitalManhasset, NYHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
North Shore Lij Medical Group At North Nassau, Pc761815455020

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samir Derisavifard allows following entities to bill medicare on his behalf.
Entity NameNorth Shore Lij Medical Group At North Nassau, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700175270
PECOS PAC ID: 7618154550
Enrollment ID: O20110602000255
Entity NameNorth Shore-lij Medical Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053688572
PECOS PAC ID: 3375701568
Enrollment ID: O20120220000262

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samir Derisavifard is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Samir Derisavifard, MD
9225 Queens Blvd Fl 2,
Rego Park, NY 11374

Ph: () -		Samir Derisavifard, MD
9225 Queens Blvd Fl 2,
Rego Park, NY 11374

Ph: (817) 925-6200

Reviews and Comments


Urology Doctors in Rego Park, NY

Dr. Michael Yuan Shy, M.D. PH.D.
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 92-29 Queens Blvd., Suite 2b, Rego Park, NY 11374
Phone: 718-606-6912    Fax: 718-606-6914
Alek Mishail, M.D.
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 9971 65th Rd Fl 1, Rego Park, NY 11374
Phone: 718-606-0909    Fax: 718-374-6999

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.