Yuri Mikhail Shimonov, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

310335 Issued in NY

Practice address

9831 65TH Rd Apt 3E
Rego Park, NY 11374-3515

Phone

(347) 653-4872

NPI assigned

Sep 24, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ys NP in Adult Health and RS NP in Family Health PLLC

  • Internal Medicine Physician
  • Maspeth, NY
  • NPI 1114766060
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1346911732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9831 65TH RD APT 3E",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743515",
            "telephone_number": "347-653-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9831 65TH RD APT 3E",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743515",
            "telephone_number": "347-653-4872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3709 Flatlands Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112343507",
            "country_code": "US",
            "telephone_number": "718-444-7766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIMONOV",
        "first_name": "YURI",
        "middle_name": "MIKHAIL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-24",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ru-Shin Shieh, M.A., CCC-SLP
• Rosana Shields, LMHC
• Olga Shimanova
• Toru Shimoji
• Esther Shimonov, PHARM.D RPH
• Olga Shimonova
• Israel Shimunov, DDS
• Julie A Shimunov
• Liana Shimunova
• Sung Jae Shin, LCSW

• Adult Health Nurse Practitioner in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.