Individual provider Active NPI

Yelena M Vevitsis, R-PAC

  • Dermatology Physician
  • Brooklyn, NY
National Provider Identifier
1013248103
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
009123 Issued in NY
Practice address
1220 Avenue P
Brooklyn, NY 11229-1009
Phone
(718) 375-7546
Fax
(718) 376-6475
NPI assigned
Jan 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 009123 NY Primary

Addresses

Primary practice location

1220 Avenue P
Brooklyn, NY 11229-1009

Mailing address

1220 Avenue P
Brooklyn, NY 11229-1009
Phone (718) 375-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology Laser and Cosmetic Surgery P.C. Dermatology PastSince May 1, 2008 Accepting new patients
Alexander Rabinovich Medical PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1013248103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 AVENUE P",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291009",
            "telephone_number": "718-375-7546",
            "fax_number": "718-376-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 AVENUE P",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291009",
            "telephone_number": "718-375-7546",
            "fax_number": "718-376-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEVITSIS",
        "first_name": "YELENA",
        "middle_name": "M",
        "credential": "R-PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "009123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.