Individual provider Active NPI

Yelena Lakhchakova, PA

  • Medical Physician Assistant
  • Rego Park, NY
National Provider Identifier
1225278153
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
007335 Issued in NY
Practice address
9785 Queens Blvd
Rego Park, NY 11374-3319
Phone
(718) 261-9100
Fax
(718) 261-6483
NPI assigned
Mar 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 007335 NY Primary

Addresses

Primary practice location

9785 Queens Blvd
Rego Park, NY 11374-3319

Mailing address

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Other identifiers 1

IdentifierTypeStateIssuer
007335OtherNYLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ylakhchakova24096@nyumc.direct-ci.com

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
I20181009003261 NY Practitioner - Physician Assistant 9638421225 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Aug 27, 2018 Accepting new patients
New York University CurrentSince Aug 27, 2018 Accepting new patients

Locations

530 1st Ave
#14
New York, NY 10016
Phone (212) 263-0980

9785 Queens Blvd
Rego Park, NY 11374
Phone (631) 360-0266

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Organizations & group practices 2

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": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1225278153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9785 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743319",
            "telephone_number": "718-261-9100",
            "fax_number": "718-261-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9785 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743319",
            "telephone_number": "718-261-9100",
            "fax_number": "718-261-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKHCHAKOVA",
        "first_name": "YELENA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "007335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "007335",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ylakhchakova24096@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "530 1st Ave # Hcc14",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.