Individual provider Active NPI

Lyudmila Shelestovsky

  • Physician Assistant
  • Vestal, NY
National Provider Identifier
1265060859
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025953 Issued in NY
Practice address
4433 Vestal Pkwy E
Vestal, NY 13850-3556
Phone
(607) 771-2220
Fax
(607) 251-2635
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 025953 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4433 Vestal Pkwy E
Vestal, NY 13850-3556

Mailing address

33 Lewis Rd Ste 2
Binghamton, NY 13905-1040
Phone (607) 770-0025

Other names 1

  • Lyudmila Levitskaya Former name

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
I20210122002136 NY Practitioner - Physician Assistant 0244644813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Medical Associates PCGroup PAC ID 0345144978, 229 clinicians

Practice addresses (Care Compare)

30 Harrison St
Suite 101
Johnson City, NY 13790-2161
Phone (607) 763-8181

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6622

Hospital & facility affiliations

  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394
  • Chenango Memorial Hospital Hospital, Norwich, NY, CCN 330033

Merit-based Incentive Payment System (MIPS)

Final score
87.59 of 100Reported as group
Quality
78.3
Promoting interoperability
100
Improvement activities
40
Cost
72.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025953NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Services Hospitals, Inc. CurrentSince Jan 18, 2021 Accepting new patients
United Medical Associates PC CurrentSince Jan 3, 2022 Accepting new patients

Locations

33 Lewis Rd
Ste 2
Binghamton, NY 13905

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

4433 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 762-2176

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.

Hospital & facility affiliations 3

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1265060859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD STE 2",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139051040",
            "telephone_number": "607-770-0025",
            "fax_number": "607-729-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503556",
            "telephone_number": "607-771-2220",
            "fax_number": "607-251-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELESTOVSKY",
        "first_name": "LYUDMILA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025953",
            "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": [
        {
            "first_name": "LYUDMILA",
            "last_name": "LEVITSKAYA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.