Individual provider Active NPI

Oksana Yakubova, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1154484426
Registry record updated Apr 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
050150 Issued in NY
Practice address
161 Madison Ave RM 8NE
New York, NY 10016-5467
Phone
(212) 532-3893
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 050150 NY Primary

Addresses

Primary practice location

161 Madison Ave RM 8NE
New York, NY 10016-5467

Mailing address

9945 65TH Ave
Rego Park, NY 11374-3652
Phone (718) 459-9560

Other identifiers 1

IdentifierTypeStateIssuer
02592345MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180130000624 NY Order and Referring Only - DentistPractitioner - Dentist 0446510036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation Past Accepting new patients
Quality Dental Care of Ny General Practice Past Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: oyakubova684623@nychhc.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209168000000",
    "number": "1154484426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9945 65TH AVE",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743652",
            "telephone_number": "718-459-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MADISON AVE RM 8NE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165467",
            "telephone_number": "212-532-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUBOVA",
        "first_name": "OKSANA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02592345",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.