Active NPI
Yekaterina Yusupova, O.D. / M.S.
- Optometrist
- Brooklyn, NY
National Provider Identifier
1164802401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV008258
- Practice address
- 490 5TH Ave
Brooklyn, NY 11215-8031 - Phone
- (718) 832-1100
- NPI assigned
- Jun 2, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV008258 | NY | Primary |
Addresses
Primary practice location
490 5TH Ave
Brooklyn, NY 11215-8031
Mailing address
490 5TH Ave
Brooklyn, NY 11215-8031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 2013
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
6607 99TH St
Apt 2F
Rego Park, NY 11374-4359
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV008258 | NY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437264000000",
"number": "1164802401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "490 5TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112158031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 5TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112158031",
"telephone_number": "718-832-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUSUPOVA",
"first_name": "YEKATERINA",
"name_prefix": "Dr.",
"credential": "O.D. / M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-02",
"last_updated": "2015-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV008258",
"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 Jul 19, 2015; 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.