Bella Yagolkovskaya, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704212997 Issued in MI

Practice address

3555 W 13 Mile Rd Ste N120
Royal Oak, MI 48073-6710

Phone

(248) 551-7370

Fax

(248) 551-8190

NPI assigned

Mar 16, 2009

Last updated

Oct 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: byagolkovskaya1262477@epic00.shdirect.org

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1346481637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1862",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 W 13 MILE RD STE N120",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-551-7370",
            "fax_number": "248-551-8190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44199 Dequindre Rd Ste 615",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851128",
            "country_code": "US",
            "telephone_number": "248-964-9660",
            "fax_number": "248-964-9665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAGOLKOVSKAYA",
        "first_name": "BELLA",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704212997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "byagolkovskaya459051@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3555 W 13 Mile Rd Ste N120",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Elizabeth Wydra, MS, CCC-SLP
• Michael Wayne Wyrick, PTA
• Collette M Wyte, M.D.
• Mahmoud Magdi Moustafa Yacout
• Sailaja Yadavalli, MD
• John A Yakamovich II, MA, LLP
• Marjorie Yaker, LMSW
• Arieg Yalda
• Renee Lourdes Yaldoo, MSW
• Branden Jalal Yaldou, M.D.

• Pediatric Nurse Practitioner in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.