Individual provider Active NPI

Yael Abdurahmanov

  • Physician Assistant
  • New York, NY
National Provider Identifier
1295494532
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
030498 Issued in NY
Practice address
143 W 29TH St FL 5
New York, NY 10001-5150
Phone
(201) 308-6622
NPI assigned
Dec 14, 2021
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 030498 NY Primary

Addresses

Primary practice location

143 W 29TH St FL 5
New York, NY 10001-5150

Mailing address

6711 171St St
Fresh Meadows, NY 11365-3311
Phone (631) 335-0050

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
I20251118000167 NY Practitioner - Physician Assistant 7911498035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Coast Rehabilitation IncGroup PAC ID 1456261437, 3 clinicians

Practice addresses (Care Compare)

1308 Edward L Grant Hwy
Bronx, NY 10452-3144
Phone (718) 538-8343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030498NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Coast Rehabilitation Inc CurrentSince Oct 21, 2025 Accepting new patients
New York Metropolitan Orthopaedics and Spine, LLC CurrentSince Mar 17, 2024 Accepting new patients
Hudson Orthopedics PLLC CurrentSince Jun 9, 2024 Accepting new patients

Locations

1221 Jerome Ave
Bronx, NY 10452
Phone (718) 358-8343

143 W 29th St
Fl 5
New York, NY 10001
Phone (646) 650-2229

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1295494532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6711 171ST ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653311",
            "telephone_number": "631-335-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 W 29TH ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015150",
            "telephone_number": "201-308-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDURAHMANOV",
        "first_name": "YAEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.