Individual provider Active NPI

Lyudmila Fuzaylova, FNP

  • Family Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1083013197
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F337547-1 Issued in NY
Practice address
7224 Kissena Blvd Ste 1H
Flushing, NY 11367-2716
Phone
(718) 576-4652
Fax
(718) 576-4652
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F337547-1 NY Primary

Addresses

Primary practice location

7224 Kissena Blvd Ste 1H
Flushing, NY 11367-2716

Mailing address

10525 65TH Ave Apt 4H
Forest Hills, NY 11375-1802
Phone (646) 704-3705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141015002026 NY Practitioner - Nurse Practitioner 5496976474 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F337547-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Apr 1, 2015 Accepting new patients
North Shore-Lij Medical PC CurrentSince Apr 1, 2015 Accepting new patients
N K Shah Medical PC CurrentSince Jul 1, 2017 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

10828 68th Dr
Forest Hills, NY 11375
Phone (718) 261-9245

20507 Hillside Ave
Ste 12
Hollis, NY 11423
Phone (718) 464-6700

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

Networks

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

Organizations & group practices 3

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1083013197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10525 65TH AVE APT 4H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751802",
            "telephone_number": "646-704-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7224 KISSENA BLVD STE 1H",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672716",
            "telephone_number": "718-576-4652",
            "fax_number": "718-576-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUZAYLOVA",
        "first_name": "LYUDMILA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337547-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.