Active NPI
Yelena Yakutilova, PA
- Pulmonary Disease Physician
- Brooklyn, NY
National Provider Identifier
1073129110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 024298
- Practice address
- 5321 Flatlands Ave
Brooklyn, NY 11234-2322 - Phone
- (718) 517-2244
- NPI assigned
- Sep 22, 2020
- Last updated
- Sep 22, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 024298 | NY | |
| Pulmonary Disease Physician | 207RP1001X | 024298 | NY | Primary |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | 024298 | NY |
Addresses
Primary practice location
5321 Flatlands Ave
Brooklyn, NY 11234-2322
Mailing address
6333 Alderton St
Rego Park, NY 11374-2824
Phone (917) 843-6436
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | PracticeFusion | Health Information Exchange (HIE) |
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024298 | NY | MD | Massage Therapist |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FAHIAD/Endpoint/FAHIAD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600732800000",
"number": "1073129110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6333 ALDERTON ST",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742824",
"telephone_number": "917-843-6436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5321 FLATLANDS AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112342322",
"telephone_number": "718-517-2244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAKUTILOVA",
"first_name": "YELENA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-22",
"last_updated": "2020-09-22",
"certification_date": "2020-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "NY",
"license": "024298",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "024298",
"primary": true
},
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "NY",
"license": "024298",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "PracticeFusion",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "5321 Flatlands Ave",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112342322",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.