Individual provider Active NPI

Uriel Avezbadalov, M.D.

  • General Practice Physician
  • Flushing, NY
National Provider Identifier
1235311010
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
246250 Issued in NY
Practice address
7908 147TH St Apt B8
Flushing, NY 11367-3760
Phone
(718) 380-8683
NPI assigned
Dec 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 246250 NY
General Practice Physician 208D00000X 246250 NY Primary

Addresses

Primary practice location

7908 147TH St Apt B8
Flushing, NY 11367-3760

Mailing address

7908 147TH St Apt B8
Flushing, NY 11367-3760
Phone (718) 380-8683

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080724000743 NY Practitioner - Internal MedicinePractitioner - PsychiatryPractitioner - Emergency Medicine 0244303170 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
246250NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Williamsburg Services LLC Past Accepting new patients
Hamilton Park Multicare Past Accepting new patients
Kingsbrook Medical Associates, PC Past Accepting new patients
Bedford Stuy Emergency Physicians Past Accepting new patients
Kingsbrook Medical Associates PC Past Accepting new patients
Willoughby Rehabilitation and Health Care Center LLC Past Accepting new patients

Organizations & group practices 6

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": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1235311010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7908 147TH ST APT B8",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673760",
            "telephone_number": "718-380-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7908 147TH ST APT B8",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673760",
            "telephone_number": "718-380-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVEZBADALOV",
        "first_name": "URIEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "246250",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "246250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.