Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Amiela Mordukhayev

Individual provider Family Nurse Practitioner · NPI 1053279265

Amiela Mordukhayev is a Nurse Practitioner in Middle Village, New York. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2026

Practice location Address checks out

6366 79th St
Middle Village, NY 11379-1310
Phone: (917) 655-1198
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 358757 (NY)

Record details

NPI number1053279265
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 14, 2026
Last updated in NPPESJanuary 27, 2026
Certification dateJanuary 27, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Middle Village