Individual ProviderSeigo NishidaSurgeryAllopathic & Osteopathic PhysiciansPractice Address100 Woods Rd, Valhalla, NY 10595-1530(914) 493-8916(914) 909-9018PECOS EnrollmentBased on the most recent information from CMS, provider Seigo Nishida is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:14 PM.Profile DetailsProvider ID1659337533Provider TypeIndividualFull NameNishida, SeigoCredentialMDGenderMaleSole ProprietorNoEnumeration Date4/21/2006Last Updated2/22/2021Contact InformationPractice LocationPractice Address100 Woods Rd, Valhalla, NY 10595-1530Phone(914) 493-8916Fax(914) 493-1097Mailing LocationMailing Address19 Bradhurst Ave Ste 3100n, Hawthorne, NY 10532-2140Phone(914) 909-9018Fax(914) 909-9028Provider TaxonomiesCodeDescriptionLicenseCode208600000XPrimaryDescriptionSurgeryAllopathic & Osteopathic PhysiciansLicense291017New YorkCode204F00000XDescriptionTransplant SurgeryAllopathic & Osteopathic PhysiciansLicenseMFC1398FloridaProvider IdentifiersIDDescriptionIssuerID2606321-00DescriptionMedicaidIssuerUnlistedFloridaID04172547DescriptionMedicaidIssuerUnlistedNew York