NPIMap

Organization Active NPI

Elina Yushuvayev MD, P.C.

  • Internal Medicine Physician
  • Bayside, NY
National Provider Identifier
1114547767
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ELINA YUSHUVAYEV MD, P.C.
Practice address
22215 Northern Blvd Lbby a
Bayside, NY 11361-3603
Phone
(718) 215-0020
Fax
(616) 226-4785
NPI assigned
Apr 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Authorized official

Name
Dr. Elina Yushuvayev, MDNPI 1093002339
Title
Attending
Phone
(718) 215-0020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

22215 Northern Blvd Lbby a
Bayside, NY 11361-3603

Mailing address

22215 Northern Blvd Ste Lobbya
Bayside, NY 11361-3678
Phone (718) 215-0020

Other names 1

  • NUFACE MEDICAL SPA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201208003010 NY Part B Supplier - Clinic/Group Practice 7315359718 Receives reassigned benefits from 1 practitioner
Practice locations: Bayside, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605139200000",
    "number": "1114547767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22215 NORTHERN BLVD STE LOBBYA",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613678",
            "telephone_number": "718-215-0020",
            "fax_number": "616-226-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22215 NORTHERN BLVD LBBY A",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613603",
            "telephone_number": "718-215-0020",
            "fax_number": "616-226-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELINA YUSHUVAYEV MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "YUSHUVAYEV",
        "authorized_official_first_name": "ELINA",
        "authorized_official_title_or_position": "ATTENDING",
        "authorized_official_telephone_number": "718-215-0020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NUFACE MEDICAL SPA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.