Ruslan Mamedov, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

8001 Bay Pkwy
Apt 1D
Brooklyn, NY 11214-1957

Phone

(718) 240-8075

NPI assigned

Jan 17, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

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

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.

• Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1720028772
  Medicare reassignment NPD
• Interfaith Professional Physician Services, P.C.

  • Allergy Physician
  • Brooklyn, NY
  • NPI 1457643991
  Medicare reassignment
• Interfaith Emergency Medicine, P.C.

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1457643785
  NPD

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1174894521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 BAY PKWY",
            "address_2": "APT 1D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112141957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 BAY PKWY",
            "address_2": "APT 1D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112141957",
            "telephone_number": "718-240-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMEDOV",
        "first_name": "RUSLAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-17",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farangiz Mamadayozova
• Wadia Mamania
• Mamassage LLC
• Ruslana Mamayev, DPT
• Cassandra Mamby
• Feride Mamedova, RN
• Veronica Mamedova, SLP-CCC
• Monika Mamidwar, M.D
• Imir Mamirov
• Aleksandr Mamkin, MSW

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.