Individual provider Active NPI

Tatyana Uvaydova

  • Certified Registered Nurse Anesthetist
  • Queens Village, NY
National Provider Identifier
1245156421
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
746749 Issued in NY
Practice address
21816 Peck Ave
Queens Village, NY 11427-1120
Phone
(917) 650-1777
NPI assigned
Jun 24, 2026
Last updated
Jun 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 746749 NY
Certified Registered Nurse Anesthetist 367500000X 746749 NY Primary

Addresses

Primary practice location

21816 Peck Ave
Queens Village, NY 11427-1120

Mailing address

21816 Peck Ave
Queens Village, NY 11427-1120
Phone (917) 650-1777

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

NPI Registry JSON

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

{
    "created_epoch": "1782259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1245156421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21816 PECK AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271120",
            "telephone_number": "917-650-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21816 PECK AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271120",
            "telephone_number": "917-650-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UVAYDOVA",
        "first_name": "TATYANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-24",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "746749",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "746749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.