Organization Active NPI

Belladonna Medical PC

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1134413891
Registry record updated May 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
BELLADONNA MEDICAL PC
Practice address
6410 Veterans Ave
Brooklyn, NY 11234-5605
Phone
(718) 209-6400
NPI assigned
May 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2011

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

Authorized official

Name
Dr. Shawn I Yunayev, M.D.NPI 1710293048
Title
President
Phone
(646) 492-4542

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

6410 Veterans Ave
Brooklyn, NY 11234-5605

Mailing address

2020 Avenue V
5G
Brooklyn, NY 11229-4555
Phone (646) 492-4542

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110912000261 NY Part B Supplier - Clinic/Group Practice 0941471551 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

6410 Veterans Ave
Ste 103
Brooklyn, NY 11234
Phone (718) 209-6400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5551d496-d540-4465-98ab-26d3cd0731b3/

Practitioners & affiliated clinicians

Practitioners 3

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": "1306713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306713600000",
    "number": "1134413891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 AVENUE V",
            "address_2": "5G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294555",
            "telephone_number": "646-492-4542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 VETERANS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345605",
            "telephone_number": "718-209-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLADONNA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-30",
        "last_updated": "2011-05-30",
        "status": "A",
        "authorized_official_last_name": "YUNAYEV",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-492-4542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2011; 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.