Active NPI
Yefim Simkhayev, OT
- Pediatric Occupational Therapist
- Brooklyn, NY
National Provider Identifier
1083180301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- P11701
- Practice address
- 1317 52ND St
Brooklyn, NY 11219 - Phone
- (718) 928-9564
- NPI assigned
- Oct 15, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | P11701 | NY | Primary |
Addresses
Primary practice location
1317 52ND St
Brooklyn, NY 11219
Mailing address
221 Crowells Rd
Edison, NJ 08817-4941
Phone (917) 201-8425
Other practice location 1
1317 52nd St
Brooklyn, NY 11219-3803
Phone (718) 928-9564
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P11701 | Medicaid | NY | |
| 814726107 | Other | NY | INDEPENDENT AGENCY |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P11701 | NY | MD | Pediatric Occupational Therapist |
| 024996 | NY | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| L Haalos Inc | Single Specialty | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Organizations & group practices 1
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": "1539561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539561600000",
"number": "1083180301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 CROWELLS RD",
"city": "EDISON",
"state": "NJ",
"postal_code": "088174941",
"telephone_number": "917-201-8425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1317 52ND ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11219",
"telephone_number": "718-928-9564"
}
],
"practiceLocations": [
{
"address_1": "1317 52nd St",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112193803",
"country_code": "US",
"telephone_number": "718-928-9564",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMKHAYEV",
"first_name": "YEFIM",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-15",
"last_updated": "2018-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "P11701",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "P11701",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT AGENCY",
"identifier": "814726107",
"state": "NY"
}
],
"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 Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.