Individual provider Active NPI

Yuliya Zagorudko, PA-C

  • Surgical Physician Assistant
  • Newark, NJ
National Provider Identifier
1427736131
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00777600 Issued in NJ
Practice address
140 Bergen St
Newark, NJ 07103-2425
Phone
(973) 972-9000
NPI assigned
Jul 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00777600 NJ Primary

Addresses

Primary practice location

140 Bergen St
Newark, NJ 07103-2425

Mailing address

18 Marryott St
Monroe TWP, NJ 08831-1654
Phone (917) 587-8648

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251208000097 NJ Practitioner - Physician Assistant 5890288807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 Bergen St
Newark, NJ 07103-2496
Phone (973) 972-4300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00777600NJMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc CurrentSince Nov 1, 2025 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Nov 1, 2025 Accepting new patients

Locations

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320

205 S Orange Ave
Ste 1200
Newark, NJ 07103
Phone (973) 972-2151

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1427736131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MARRYOTT ST",
            "city": "MONROE TWP",
            "state": "NJ",
            "postal_code": "088311654",
            "telephone_number": "917-587-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAGORUDKO",
        "first_name": "YULIYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00777600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.