Active NPI
Anatoli Yoshovayev, P.T.
- Physical Therapist
- Fresh Meadows, NY
National Provider Identifier
1104095777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 029274
- Practice address
- 7340 172ND St
Fresh Meadows, NY 11366-1421 - Phone
- (718) 291-1513
- NPI assigned
- Feb 27, 2008
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 029274 | NY | Primary |
Addresses
Primary practice location
7340 172ND St
Fresh Meadows, NY 11366-1421
Mailing address
7340 172ND St
Fresh Meadows, NY 11366-1421
Phone (718) 850-6345
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 262275638 | Other | NY | TAX ID |
| G300000050 | Other | NY | MEDICARE GHI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
47 Orient Way
Rutherford, NJ 07070-2040
Phone (973) 910-0307
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029274 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Rehab P T PC | Physical Therapist | Current | Accepting new patients |
| Ib Family Medical PC | Past | Accepting new patients | |
| Neuromuscular Physical Therapy P.C. | Past | Accepting new patients |
Locations
316 N 6th St
Prospect Park, NJ 07508
Phone (201) 200-1616
47 Orient Way
Fl 2C
Rutherford, NJ 07070
Phone (973) 910-0307
55 Meadowlands Pkwy
Fl 3
Secaucus, NJ 07094
Phone (201) 392-3588
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.
-
- Family Medicine Physician
- Brooklyn, NY
- NPI 1386832913
-
- Specialist
- New York, NY
- NPI 1396906426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545004800000",
"number": "1104095777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7340 172ND ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113661421",
"telephone_number": "718-850-6345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7340 172ND ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113661421",
"telephone_number": "718-291-1513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOSHOVAYEV",
"first_name": "ANATOLI",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-27",
"last_updated": "2018-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "029274",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "262275638",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GHI",
"identifier": "G300000050",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fresh Meadows, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.