Evgenia Mayvaldov, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

304546 Issued in NY

Practice address

300 Community Dr
Manhasset, NY 11030-3876

Phone

(516) 562-2350

NPI assigned

May 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Evgenia Taiblin Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vanguard DermatologyGroup PAC ID 2365475977, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

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.

• Vanguard Dermatology

  • Specialist
  • Brooklyn, NY
  • NPI 1619179009
  Medicare reassignment Care Compare group NPD
• Evgenia Mayvaldov Nurse Practitioner in Gerontology PC

  • Nurse Practitioner
  • Oceanside, NY
  • NPI 1326990144
  NPD Authorized official
• Amb Medical Services, P.C.

  • Family Medicine Physician
  • Hauppauge, NY
  • NPI 1568534766
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1427261890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 PRISCILLA RD",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981817",
            "telephone_number": "516-661-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303876",
            "telephone_number": "516-562-2350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6433 98th St",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113743321",
            "country_code": "US",
            "telephone_number": "718-975-7546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYVALDOV",
        "first_name": "EVGENIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "304546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVGENIA",
            "last_name": "TAIBLIN",
            "credential": "MSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alejandro Matus
• Jonathan K Mau, MD
• Adam W Mauer, MD
• Simon Maybaum, MD
• Sarah Anne Aguilar Mayo
• Susan Jane Mazer
• Cynthia Mazile, PA
• Jill B. McCarney, RN
• Bryan McCarty, MD
• Andrea Marie McCloy, FNP

• Adult Health Nurse Practitioner in Manhasset, NY
• Providers in Manhasset, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.