Individual provider Active NPI

Yevgeniya Kitaychik, PA

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1205807476
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010355 Issued in NY
Practice address
2942 W 5TH St Apt 9F
Brooklyn, NY 11224-3815
Phone
(718) 373-3961
NPI assigned
Jan 27, 2006
Last updated
Apr 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 010355 NY Primary

Addresses

Primary practice location

2942 W 5TH St Apt 9F
Brooklyn, NY 11224-3815

Mailing address

2942 W 5TH St
Apt11P
Brooklyn, NY 11224-3834
Phone (718) 373-3961

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200826002215 NY Order and Referring Only - Physician Assistant 1850307265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1205807476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2942 W 5TH ST",
            "address_2": "APT11P",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112243834",
            "telephone_number": "718-373-3961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2942 W 5TH ST APT 9F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112243815",
            "telephone_number": "718-373-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITAYCHIK",
        "first_name": "YEVGENIYA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.