Organization Active NPI

Ys NP in Adult Health and RS NP in Family Health PLLC

  • Internal Medicine Physician
  • Maspeth, NY
National Provider Identifier
1114766060
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
YS NP IN ADULT HEALTH AND RS NP IN FAMILY HEALTH PLLC
Practice address
6519 Borden Ave BSMT
Maspeth, NY 11378-1630
Phone
(718) 255-3346
NPI assigned
May 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Authorized official

Name
Yuri ShimonovNPI 1346911732
Title
Owner
Phone
(718) 255-3346

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 SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

6519 Borden Ave BSMT
Maspeth, NY 11378-1630

Mailing address

6519 Borden Ave BSMT
Maspeth, NY 11378-1630

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251205000971 NY Part B Supplier - Clinic/Group Practice 2163915331 Receives reassigned benefits from 1 practitioner
Practice locations: Maspeth, NY

National Provider Directory

National Provider Directory

Locations

6519 Borden Ave
Bsmt
Maspeth, NY 11378
Phone (718) 255-3346

Practitioners & affiliated clinicians

Practitioners 1

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": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1114766060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6519 BORDEN AVE BSMT",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113781630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6519 BORDEN AVE BSMT",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113781630",
            "telephone_number": "718-255-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YS NP IN ADULT HEALTH AND RS NP IN FAMILY HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "SHIMONOV",
        "authorized_official_first_name": "YURI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-255-3346"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maspeth, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.