Individual provider Active NPI

Lyubov Izyayeva, NP

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1295046449
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305307-1 Issued in NY
Practice address
2195 E 22ND St
#1C
Brooklyn, NY 11229-3602
Phone
(718) 648-4545
Fax
(718) 648-7788
NPI assigned
Jun 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F305307-1 NY Primary

Addresses

Primary practice location

2195 E 22ND St
#1C
Brooklyn, NY 11229-3602

Mailing address

2195 E 22ND St
#1C
Brooklyn, NY 11229-3602
Phone (718) 648-4545

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
I20180323001037 NY Practitioner - Nurse Practitioner 1355603762 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F305307-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Feb 6, 2018 Accepting new patients
Maimonides Medical Center General Surgery FPP CurrentSince Feb 6, 2018 Accepting new patients
MMC Surgical Oncology Associates Past Accepting new patients

Locations

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

745 64th St
Ste 2
Brooklyn, NY 11220
Phone (718) 283-7602

745 64th St
Brooklyn, NY 11220
Phone (718) 765-2570

Networks

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

Interoperability endpoints

  • Direct secure messaging: lyubovizyayeva@mai.allscriptsdirect.net

Organizations & group practices 4

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": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1295046449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 E 22ND ST",
            "address_2": "#1C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293602",
            "telephone_number": "718-648-4545",
            "fax_number": "718-648-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 E 22ND ST",
            "address_2": "#1C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293602",
            "telephone_number": "718-648-4545",
            "fax_number": "718-648-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZYAYEVA",
        "first_name": "LYUBOV",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305307-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.