Individual provider Active NPI

Bella Yushuvayev, PA

  • Physician Assistant
  • Glendale, NY
National Provider Identifier
1467756841
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013567 Issued in NY
Practice address
8340 Woodhaven Blvd
Glendale, NY 11385-7824
Phone
(718) 441-4444
Fax
(718) 441-4487
NPI assigned
Dec 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013567 NY Primary

Addresses

Primary practice location

8340 Woodhaven Blvd
Glendale, NY 11385-7824

Mailing address

8340 Woodhaven Blvd
Glendale, NY 11385-7824
Phone (718) 441-4444

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
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: bey9011@direct.nyp.org

NPI Registry JSON

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1467756841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8340 WOODHAVEN BLVD",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857824",
            "telephone_number": "718-441-4444",
            "fax_number": "718-441-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8340 WOODHAVEN BLVD",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857824",
            "telephone_number": "718-441-4444",
            "fax_number": "718-441-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSHUVAYEV",
        "first_name": "BELLA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-29",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; 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.