Organization Active NPI

Prestige Y Corp

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1417611435
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PRESTIGE Y CORP
Practice address
199 Highlawn Ave
Brooklyn, NY 11223-2647
Phone
(718) 759-6523
NPI assigned
Oct 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Authorized official

Name
Yuriy Stogniy
Title
Director
Phone
(718) 759-6523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

199 Highlawn Ave
Brooklyn, NY 11223-2647

Mailing address

199 Highlawn Ave
Brooklyn, NY 11223-2647
Phone (718) 759-6523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230502000361 NY Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2668837394 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

199 Highlawn Ave
Brooklyn, NY 11223
Phone (718) 759-6523

274 W Broadway
Long Beach, NY 11561
Phone (516) 431-1400

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1417611435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 HIGHLAWN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112232647",
            "telephone_number": "718-759-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 HIGHLAWN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112232647",
            "telephone_number": "718-759-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE Y CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "STOGNIY",
        "authorized_official_first_name": "YURIY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-759-6523"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.