Active NPI
Robert Yusupov
- Optician
- Astoria, NY
National Provider Identifier
1366728396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 007608
- Practice address
- 32-41 Steinway Street
Astoria, NY 11103 - Phone
- (347) 808-9155
- Fax
- (347) 808-9156
- NPI assigned
- Oct 21, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 007608 | NY | Primary |
Addresses
Primary practice location
32-41 Steinway Street
Astoria, NY 11103
Mailing address
32-41A Steinway Street
Astoria, NY 11103
Phone (347) 808-9155
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
| License | State | Type | Specialty |
|---|---|---|---|
| 007608 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indigo Optical Center | Past | 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.
-
- Durable Medical Equipment & Medical Supplies
- Astoria, NY
- NPI 1750829933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319155200000",
"number": "1366728396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32-41A STEINWAY STREET",
"city": "ASTORIA",
"state": "NY",
"postal_code": "11103",
"telephone_number": "347-808-9155",
"fax_number": "347-808-9156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32-41 STEINWAY STREET",
"city": "ASTORIA",
"state": "NY",
"postal_code": "11103",
"telephone_number": "347-808-9155",
"fax_number": "347-808-9156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUSUPOV",
"first_name": "ROBERT",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-21",
"last_updated": "2011-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "007608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.