Individual provider Active NPI

Miriam Yagudayeva, OTR/L

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1174035216
Registry record updated Oct 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1312 38TH St
Brooklyn, NY 11218-3612
Phone
(718) 686-3700
NPI assigned
Oct 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Specialist 174400000X NY Primary

Addresses

Primary practice location

1312 38TH St
Brooklyn, NY 11218-3612

Mailing address

1312 38TH St
Brooklyn, NY 11218-3612
Phone (718) 686-3700

Other names 1

  • Mariya Yagudayeva Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021158NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1174035216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 38TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183612",
            "telephone_number": "718-686-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 38TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183612",
            "telephone_number": "718-686-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGUDAYEVA",
        "first_name": "MIRIAM",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIYA",
            "last_name": "YAGUDAYEVA",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 30, 2017; 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.