Individual provider Active NPI

Robert Yakutilov

  • Pharmacist
  • Rego Park, NY
National Provider Identifier
1336914548
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
071083 Issued in NY
Practice address
8601 63Rd Dr
Rego Park, NY 11374-4825
Phone
(347) 458-0565
NPI assigned
Nov 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 071083 NY Primary

Addresses

Primary practice location

8601 63Rd Dr
Rego Park, NY 11374-4825

Mailing address

8601 63Rd Dr
Rego Park, NY 11374-4825
Phone (347) 458-0565

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

State licenses

LicenseStateTypeSpecialty
071083NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
R & D Chemists LLC Current Accepting new patients

Organizations & group practices 1

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": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1336914548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 63RD DR",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744825",
            "telephone_number": "347-458-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 63RD DR",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744825",
            "telephone_number": "347-458-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUTILOV",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "071083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.