Roman Yumatov, MA

Primary specialty

PsychoanalystTaxonomy code 102L00000X

License

001056 Issued in NY

Practice address

3075 Brighton 14TH St Apt 34a
Brooklyn, NY 11235-5530

Phone

(917) 602-5680

NPI assigned

Aug 26, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Roman Yumatov Andrade Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1154098267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 BRIGHTON 14TH ST APT 34A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 BRIGHTON 14TH ST APT 34A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355530",
            "telephone_number": "917-602-5680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Francisco Madero 484-2, PH",
            "address_2": "Emiliano Zapata",
            "address_purpose": "LOCATION",
            "city": "Puerto Vallarta",
            "state": "Jalisco",
            "postal_code": "48380",
            "country_code": "MX",
            "telephone_number": "322-178-6827",
            "country_name": "Mexico",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "YUMATOV",
        "first_name": "ROMAN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "001056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROMAN",
            "last_name": "YUMATOV ANDRADE",
            "credential": "MA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Psychoanalyst in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychoanalyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.