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

Mr. Rodshel Nisanov, FNP-BC

Individual provider Registered Nurse · NPI 1356005425

Mr. Rodshel Nisanov, FNP-BC is a Nurse Practitioner in Flushing, New York. Qualified in 2021, 5 years ago. Practices with Hollis Ak LLC, a 7-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2021
Specialties on file
3
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

14146 72nd Dr
Flushing, NY 11367-2313
Phone: (646) 525-5965
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 347908 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 747551 (NY)
Dermatology Physician Taxonomy 207N00000X · Licence F347908-01 (NY)

Record details

NPI number1356005425
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedOctober 26, 2021
Last updated in NPPESJune 9, 2026
Certification dateJune 9, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Hollis Ak Llc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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