NPIMap

Organization Active NPI

Sioms Forest Hills Management LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Forest Hills, NY
National Provider Identifier
1124659479
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
SIOMS FOREST HILLS MANAGEMENT LLC
Practice address
7009 Austin St Ste 201
Forest Hills, NY 11375-1012
Phone
(718) 261-2790
NPI assigned
Jan 27, 2020
Last updated
Jan 27, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SIOMS FOREST HILLSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Authorized official

Name
Steve Yusupov, MD, DDSNPI 1982991485
Title
Managing Partner
Phone
(718) 261-2790

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
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X NU Primary

Addresses

Primary practice location

7009 Austin St Ste 201
Forest Hills, NY 11375-1012

Mailing address

7009 Austin St Ste 201
Forest Hills, NY 11375-1012

Other identifiers 1

IdentifierTypeStateIssuer
03766474MedicaidNY

Other names 1

  • SIOMS Forest Hills Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Sioms Forest Hills Management LLC2 organizations share this tax ID, including this one
Part of
Sioms Forest Hills Management LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1124659479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7009 AUSTIN ST STE 201",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7009 AUSTIN ST STE 201",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751012",
            "telephone_number": "718-261-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIOMS FOREST HILLS MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SIOMS FOREST HILLS",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "YUSUPOV",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "718-261-2790",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03766474",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIOMS Forest Hills",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.