Individual provider Active NPI

Nurlan Davletalinov

  • Family Medicine Physician
  • Norton, VA
National Provider Identifier
1124905179
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0116041733 Issued in VA
Practice address
96 15TH St. NE
Suite 104
Norton, VA 24273
Phone
(276) 679-0321
Fax
(276) 439-1872
NPI assigned
Aug 20, 2025
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0116041733 VA Primary
Internal Medicine Physician 207R00000X P137752 NY

Addresses

Primary practice location

96 15TH St. NE
Suite 104
Norton, VA 24273

Mailing address

4414 47TH Ave Apt C2
Woodside, NY 11377-6115
Phone (516) 800-6882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250827002539 NY Practitioner - Internal Medicine 8224539705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3438 Bell Blvd
Suite 301
Bayside, NY 11361-1745

4414 47TH Ave
Apt C2
Woodside, NY 11377-6113

4414 47TH Ave Apt
C2
Woodside, NY 11377-6115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0116041733VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peyman Younesi MD PLLC Internal Medicine CurrentSince Aug 18, 2025 Accepting new patients

Locations

1065 Smithtown Ave
Bohemia, NY 11716
Phone (631) 388-7616

8008 45th Ave
Flushing, NY 11373
Phone (718) 373-0777

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1124905179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 47TH AVE APT C2",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113776115",
            "telephone_number": "516-800-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 15TH ST. NE",
            "address_2": "SUITE 104",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "24273",
            "telephone_number": "276-679-0321",
            "fax_number": "276-439-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVLETALINOV",
        "first_name": "NURLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-20",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116041733",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P137752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton, VA

Sources for this page

Verify at the official NPI Registry.