Dr Dmitry Lisenenkov, MD - Medicare Internal Medicine in Staten Island, NY

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Dr Dmitry Lisenenkov, MD is a medicare enrolled "Anesthesiology - Critical Care Medicine" physician in Staten Island, New York. He graduated from medical school in 2005 and has 19 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Critical Care Physicians Of New Jersey Pc, Ccmma Nj Llc, Barnabas Health Medical Group Pc and his current practice location is 475 Seaview Ave, Cardiothoracic Icu, Staten Island, New York. You can reach out to his office (for appointments etc.) via phone at (718) 775-7770.

Dr Dmitry Lisenenkov is licensed to practice in New Jersey (license number 25MA11111600) 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 1679736953.

Contact Information

Dr Dmitry Lisenenkov, MD
475 Seaview Ave, Cardiothoracic Icu,
Staten Island, NY 10305
(718) 775-7770
Not Available

Map and Direction




Physician's Profile

Full NameDr Dmitry Lisenenkov
GenderMale
SpecialityInternal Medicine
Experience19 Years
Location475 Seaview Ave, Staten Island, 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:
  • Dr Dmitry Lisenenkov graduated from medical school in 2005
  NPI Data:
  • NPI Number: 1679736953
  • Provider Enumeration Date: 07/07/2008
  • Last Update Date: 05/02/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 8820147721
  • Enrollment ID: I20211109003079

Medical Identifiers

Medical identifiers for Dr Dmitry Lisenenkov such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679736953NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RC0200XInternal Medicine - Critical Care Medicine 249407 (New York)Secondary
207LC0200XAnesthesiology - Critical Care Medicine 25MA11111600 (New Jersey)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Newark Beth Israel Medical CenterNewark, NJHospital
St Mary's General HospitalPassaic, NJHospital
Raritan Bay Medical Center Perth Amboy DivisionPerth amboy, NJHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Critical Care Physicians Of New Jersey Pc56989316995
Ccmma Nj Llc812339249520
Barnabas Health Medical Group Pc9537316955567

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. Dr Dmitry Lisenenkov allows following entities to bill medicare on his behalf.
Entity NameNbimc Department Of Cardio-thoracic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538127204
PECOS PAC ID: 4082696794
Enrollment ID: O20040607000106
Entity NameCritical Care Physicians Of New Jersey Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1154682680
PECOS PAC ID: 5698931699
Enrollment ID: O20120719000039
Entity NameBarnabas Health Medical Group Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841557246
PECOS PAC ID: 9537316955
Enrollment ID: O20120820000951
Entity NameCcmma Nj Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124543095
PECOS PAC ID: 8123392495
Enrollment ID: O20170926000361

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. Dr Dmitry Lisenenkov 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
Dr Dmitry Lisenenkov, MD
475 Seaview Ave,
Staten Island, NY 10305-3436

Ph: (718) 775-7770		Dr Dmitry Lisenenkov, MD
475 Seaview Ave, Cardiothoracic Icu,
Staten Island, NY 10305

Ph: (718) 775-7770

Reviews and Comments


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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.

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