Individual provider Active NPI

Ruslan Sushkov, RN

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1467798769
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
654810 Issued in NY
Practice address
1310 Avenue R Apt 5L
Brooklyn, NY 11229-2838
Phone
(917) 325-6904
NPI assigned
Dec 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 654810 NY Primary

Addresses

Primary practice location

1310 Avenue R Apt 5L
Brooklyn, NY 11229-2838

Mailing address

1310 Avenue R Apt 5L
Brooklyn, NY 11229-2838
Phone (917) 325-6904

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
654810NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1467798769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 AVENUE R APT 5L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292838",
            "telephone_number": "917-325-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 AVENUE R APT 5L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292838",
            "telephone_number": "917-325-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSHKOV",
        "first_name": "RUSLAN",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-14",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "654810",
            "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 Dec 14, 2012; 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.