Individual provider Active NPI

Vladimir Yakubov, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1407995996
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16924701 Issued in NY
Practice address
1516 Oriental Blvd
Brooklyn, NY 11235-2328
Phone
(718) 646-4441
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16924701 NY Primary

Addresses

Primary practice location

1516 Oriental Blvd
Brooklyn, NY 11235-2328

Mailing address

1516 Oriental Blvd
Brooklyn, NY 11235-2328
Phone (718) 646-4441

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110407000762 NY Practitioner - Internal Medicine 4880878321 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16924701NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Menorah Home & Hospital for the Aged & Infirm CurrentSince Feb 28, 1996 Accepting new patients

Locations

1516 Oriental Blvd
Brooklyn, NY 11235
Phone (212) 342-9301

871 Bushwick Ave
Brooklyn, NY 11221
Phone (718) 443-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1407995996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 ORIENTAL BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352328",
            "telephone_number": "718-646-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 ORIENTAL BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352328",
            "telephone_number": "718-646-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUBOV",
        "first_name": "VLADIMIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "16924701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.