Individual provider Active NPI

Yelena Pankova, FNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1457780116
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
F336022-1 Issued in NY
Practice address
2236 E 13TH St
Brooklyn, NY 11229-4304
Phone
(718) 496-1873
NPI assigned
Nov 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X F336022-1 NY Primary

Addresses

Primary practice location

2236 E 13TH St
Brooklyn, NY 11229-4304

Mailing address

2236 E 13TH St
Brooklyn, NY 11229-4304
Phone (718) 496-1873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
F336022-1NYMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1457780116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2236 E 13TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294304",
            "telephone_number": "718-496-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 E 13TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294304",
            "telephone_number": "718-496-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKOVA",
        "first_name": "YELENA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F336022-1",
            "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 Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.