Individual provider Active NPI

Yuriy Dekhkanov, MD

  • Internal Medicine Physician
  • Glendale, NY
National Provider Identifier
1235405432
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
280435 Issued in NY
Practice address
8713 Myrtle Ave
Glendale, NY 11385-7847
Phone
(718) 971-1179
Fax
(718) 971-1698
NPI assigned
Apr 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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 280435 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

8713 Myrtle Ave
Glendale, NY 11385-7847

Mailing address

8713 Myrtle Ave
Glendale, NY 11385-7847
Phone (718) 971-9509

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151203002340 NY Practitioner - HospitalistPractitioner - Internal Medicine 5092015669 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Suffolk Medical PCGroup PAC ID 0244396349, 204 clinicians
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 705-2689

259 1St St
Mineola, NY 11501-3957
Phone (516) 663-8510

301 E Main St
2 North
Bay Shore, NY 11706-8408
Phone (631) 968-3293

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
280435NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Suffolk Medical PC CurrentSince Jul 22, 2025 Accepting new patients
Southwest Suffolk Medical, P.C. CurrentSince Jul 22, 2025 Accepting new patients
New York University Internal Medicine CurrentSince Apr 14, 2020 Accepting new patients
Green Apple Medical P.C. Internal Medicine Current Accepting new patients
New York University Internal Medicine CurrentSince Apr 14, 2020 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jul 21, 2015 Accepting new patients
Internal Medicine Wellbeing PLLC Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients
South Shore University Hospital Past Accepting new patients
Mercy Medical Center Past Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

301 E Main St
#2N
Bay Shore, NY 11706
Phone (631) 968-3293

8713 Myrtle Ave
Glendale, NY 11385
Phone (718) 971-1179

8713 Myrtle Ave
#1
Glendale, NY 11385

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

300 Community Dr
Plandome, NY 11030

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: ydekhkanov352304@nyumc.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1235405432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8713 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857847",
            "telephone_number": "718-971-9509",
            "fax_number": "718-971-1698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8713 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857847",
            "telephone_number": "718-971-1179",
            "fax_number": "718-971-1698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEKHKANOV",
        "first_name": "YURIY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-02",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "280435",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

Verify at the official NPI Registry.