Individual provider Active NPI

Robert Y Yakutilov, PHARM-D

  • Pharmacist
  • Flushing, NY
National Provider Identifier
1194933341
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051224 Issued in NY
Practice address
10817 65TH Rd
Flushing, NY 11375-1842
Phone
(646) 684-7118
NPI assigned
May 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051224 NY Primary

Addresses

Primary practice location

10817 65TH Rd
Flushing, NY 11375-1842

Mailing address

10817 65TH Rd
Flushing, NY 11375-1842
Phone (646) 684-7118

Other names 1

  • Dr. Robert Y Yakutilov Professional 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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051224NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aaa Pharmacy Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1194933341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10817 65TH RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113751842",
            "telephone_number": "646-684-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10817 65TH RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113751842",
            "telephone_number": "646-684-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUTILOV",
        "first_name": "ROBERT",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "PHARM-D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-20",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "051224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "YAKUTILOV",
            "middle_name": "Y",
            "prefix": "DR.",
            "credential": "RPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.