NPIMap

Individual provider Active NPI

Bachor Siyvnova

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1043760556
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020451 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453-4303
Phone
(718) 299-7295
NPI assigned
Oct 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 020451 NY Primary

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Mailing address

2015 Grand Concourse
Bronx, NY 10453-4303
Phone (718) 299-7295

Other practice location 1

9922 62nd Ave
Rego Park, NY 11374-1470
Phone (347) 724-6957

Other practice location 2

9922 62nd Ave
Rego Park, NY 11374-1470
Phone (347) 724-6957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180912001072 NY Practitioner - Physician Assistant 3375893399 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care for You PCGroup PAC ID 6800207879, 12 clinicians

Practice addresses (Care Compare)

Uniondale, NY 11556
Phone (718) 255-7368

6711 164TH St
Fresh Meadows, NY 11365-3162
Phone (718) 961-5060

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
020451NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Oct 1, 2024 Accepting new patients
Flushing Hospital Medical Center CurrentSince Aug 1, 2024 Accepting new patients
Jamaica Hospital CurrentSince Oct 1, 2024 Accepting new patients

Locations

14601 45th Ave
Flushing, NY 11355
Phone (718) 670-5562

80 Marcus Dr
Melville, NY 11747
Phone (631) 391-7889

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: bsiyunov85852@nychhc.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1043760556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "718-299-7295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9922 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113741470",
            "country_code": "US",
            "telephone_number": "347-724-6957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9922 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113741470",
            "country_code": "US",
            "telephone_number": "347-724-6957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIYVNOVA",
        "first_name": "BACHOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-07",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.