Active NPI
Ignat Slepokourov
- Massage Therapist
- New York, NY
National Provider Identifier
1407461239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 73312
- Practice address
- 45 W 45TH St
New York, NY 10036-4602 - Phone
- (877) 438-9335
- NPI assigned
- Sep 9, 2020
- Last updated
- Sep 9, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 73312 | FL | Primary |
Addresses
Primary practice location
45 W 45TH St
New York, NY 10036-4602
Mailing address
127 Harbors Way
Boynton Beach, FL 33435-2400
Phone (561) 779-7903
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 |
|---|---|---|---|
| 73312 | FL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jamira Santiago | Massage Therapist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Massage Therapist
- Woodhaven, NY
- NPI 1356932685
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599609600000",
"number": "1407461239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 HARBORS WAY",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334352400",
"telephone_number": "561-779-7903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 W 45TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100364602",
"telephone_number": "877-438-9335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLEPOKOUROV",
"first_name": "IGNAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-09",
"last_updated": "2020-09-09",
"certification_date": "2020-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "73312",
"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 Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.