Georgiy Yusupov

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F347371-01 Issued in NY

Practice address

3709 Flatlands Ave
Brooklyn, NY 11234-3507

Phone

(718) 444-7766

NPI assigned

Mar 16, 2021

Last updated

Mar 25, 2021By the provider in NPPES

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

• Mr. Georgiy Yusupov Professional name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gyusupov@landmarkhealth-direct.org

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.

• Georgiy Yusupov Family Health Nurse Practitioner P.C.

  • Internal Medicine Physician
  • Flushing, NY
  • NPI 1003521436
  Medicare reassignment Authorized official
• Brookview Medical Associates, PLLC

  • General Practice Physician
  • Bohemia, NY
  • NPI 1871965855
  Medicare reassignment NPD

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1164007548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14020 68TH DR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671652",
            "telephone_number": "646-331-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343507",
            "telephone_number": "718-444-7766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14020 68th Dr",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113671652",
            "country_code": "US",
            "telephone_number": "646-331-5198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUSUPOV",
        "first_name": "GEORGIY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F347371-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GEORGIY",
            "last_name": "YUSUPOV",
            "prefix": "MR.",
            "credential": "FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Orkhan Yusufov
• Ruslan Yusufov
• Zarina Yusufov
• Dana Yusupov, PT, DPT
• Edward Yusupov
• Michelle Sarah Yusupov, ND
• Nikolay Yusupov, RN
• Rakhmin Yusupov, MD
• Susan Yusupov
• Yuriy Yusupov, D.D.S., M.D.

• Family Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.