Advanced Adult Health NP, PC.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

ADVANCED ADULT HEALTH NP, PC.

Practice address

2109 Matthews Ave
Bronx, NY 10462-2614

Phone

(718) 794-1000

Fax

(718) 794-5264

NPI assigned

Aug 31, 2011

Last updated

Sep 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Erik P Mordukhayev, NPNPI 1851464853

Title

President

Phone

(718) 794-1000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Erik P Mordukhayev, N.P.

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
  • NPI 1851464853
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1174804454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 MATTHEWS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104622614",
            "telephone_number": "718-794-1000",
            "fax_number": "718-794-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 MATTHEWS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104622614",
            "telephone_number": "718-794-1000",
            "fax_number": "718-794-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ADULT HEALTH NP, PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "MORDUKHAYEV",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-794-1000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yamini Adusumelli
• Christiana A Adutwum
• Advance Health RX Inc
• Advance Primary Specialty Care
• Advanced Access Medical Care, PLLC (Advanced Access Medical Care)
• Advanced Bronx Dental PLLC (Advanced Bronx Oral Surgery)
• Advanced Chiropractic of Pelham Bay P.C.
• Advanced Dermatology of Coop City PC (Advanced Dermatology Associates)
• Advanced Dermatology of New York PC (advanced dermatology associates)
• Advanced Dermatology of New York PC (Advanced Dermatology Associates)

• Adult Health Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.