Individual provider Active NPI

Denis Yusupov, MD

  • Cardiovascular Disease Physician
  • Norfolk, VA
National Provider Identifier
1427586155
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0101282246 Issued in VA
Practice address
600 Gresham Dr
Norfolk, VA 23507-1904
Phone
(757) 388-8870
NPI assigned
May 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 0101282246 VA Primary

Addresses

Primary practice location

600 Gresham Dr
Norfolk, VA 23507-1904

Mailing address

450 Clarkson Ave Dept of
Brooklyn, NY 11203-2012

Other practice location 1

450 Clarkson Ave Dept Of
Brooklyn, NY 11203-2012
Phone (718) 270-2030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240913003669 VA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1850634742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 388-3934

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Cardiovascular Disease CurrentSince Jul 1, 2024 Accepting new patients

Locations

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

824 N Military Hwy
Ste 100
Norfolk, VA 23502
Phone (888) 236-2263

301 Riverview Ave
Ste 700
Norfolk, VA 23510
Phone (757) 252-9365

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Networks

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

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1427586155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE DEPT OF",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-8870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clarkson Ave Dept Of",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "718-270-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUSUPOV",
        "first_name": "DENIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101282246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.