Individual provider Active NPI

Emiliya Mullayeva, FNP

  • Family Nurse Practitioner
  • Kew Gardens, NY
National Provider Identifier
1235445099
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F337847-1 Issued in NY
Practice address
11882 Metropolitan Ave
Kew Gardens, NY 11415-2001
Phone
(516) 300-0304
NPI assigned
Aug 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 507302-1 NY
Family Nurse Practitioner 363LF0000X F337847-1 NY Primary

Addresses

Primary practice location

11882 Metropolitan Ave
Kew Gardens, NY 11415-2001

Mailing address

126 Erika Loop
Staten Island, NY 10312-6659
Phone (917) 365-7967

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
I20190917001433 NY Practitioner - Nurse Practitioner 3274845409

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
507302-1NYMDAddiction (Substance Use Disorder) Registered Nurse
F337847-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Gregory Shifrin OBGYN PC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1235445099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 ERIKA LOOP",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126659",
            "telephone_number": "917-365-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11882 METROPOLITAN AVE",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114152001",
            "telephone_number": "516-300-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLAYEVA",
        "first_name": "EMILIYA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "507302-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337847-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

Verify at the official NPI Registry.