Individual provider Active NPI

Yelena Javakhishvili

  • Durable Medical Equipment & Medical Supplies
  • Brooklyn, NY
National Provider Identifier
1295604130
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Practice address
621 Brighton Beach Ave Ste 210
Brooklyn, NY 11235-6405
Phone
(646) 489-2696
NPI assigned
Oct 30, 2025
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NY Primary

Addresses

Primary practice location

621 Brighton Beach Ave Ste 210
Brooklyn, NY 11235-6405

Mailing address

621 Brighton Beach Ave Ste 210
Brooklyn, NY 11235-6405

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": "1761782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1295604130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 BRIGHTON BEACH AVE STE 210",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 BRIGHTON BEACH AVE STE 210",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356405",
            "telephone_number": "646-489-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVAKHISHVILI",
        "first_name": "YELENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-30",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.