Active NPI
Yakov Baghdanov
- Driver
- Beaverton, OR
National Provider Identifier
1215314034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 5651047
- Practice address
- 754 NW Fieldcrest Way Apt Q307
Beaverton, OR 97006-7741 - Phone
- (503) 961-3056
- NPI assigned
- Apr 30, 2015
- Last updated
- Apr 30, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 5651047 | OR | Primary |
Addresses
Primary practice location
754 NW Fieldcrest Way Apt Q307
Beaverton, OR 97006-7741
Mailing address
754 NW Fieldcrest Way Apt Q307
Beaverton, OR 97006-7741
Phone (503) 961-3056
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5651047 | OR | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430352000000",
"number": "1215314034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "754 NW FIELDCREST WAY APT Q307",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970067741",
"telephone_number": "503-961-3056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "754 NW FIELDCREST WAY APT Q307",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970067741",
"telephone_number": "503-961-3056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGHDANOV",
"first_name": "YAKOV",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-30",
"last_updated": "2015-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "OR",
"license": "5651047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.