Individual provider Active NPI

Oleg Polyakov

  • Massage Therapist
  • New York, NY
National Provider Identifier
1396693685
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
032225 Issued in NY
Practice address
873 Broadway
New York, NY 10003-1231
Phone
(917) 596-1443
NPI assigned
Mar 20, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X 032225 NY Primary

Addresses

Primary practice location

873 Broadway
New York, NY 10003-1231

Mailing address

108-136 MLK Jr Blvd Apt 1513
Newark, NJ 07104-5367

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": "1773964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1396693685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108-136 MLK JR BLVD APT 1513",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071045367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031231",
            "telephone_number": "917-596-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLYAKOV",
        "first_name": "OLEG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-20",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "032225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; 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.