Individual provider Active NPI

Arina Zudenko

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1477199040
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
026888 Issued in NY
Practice address
1 Brookdale PLZ
Brooklyn, NY 11212-3139
Phone
(718) 240-5000
NPI assigned
Nov 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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
Physician Assistant 363A00000X 026888 NY Primary

Addresses

Primary practice location

1 Brookdale PLZ
Brooklyn, NY 11212-3139

Mailing address

606 W 57TH St Apt 2001
New York, NY 10019-1394

Other practice location 1

606 W 57th St Apt 2001
New York, NY 10019-1394
Phone (646) 427-7929

Other identifiers 1

IdentifierTypeStateIssuer
100074753OtherTKID

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Azudenk000@citymail.cuny.edu Health Information Exchange (HIE)
Direct Messaging Address azudenk000@citymail.cuny.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20211203002314 NY Practitioner - Physician Assistant 4082004197 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026888NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Hospital Medical Center CurrentSince Aug 31, 2021 Accepting new patients
Upper East Side Medical PC PastSince Sep 19, 2013 Accepting new patients

Locations

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1477199040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 W 57TH ST APT 2001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "606 W 57th St Apt 2001",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191394",
            "country_code": "US",
            "telephone_number": "646-427-7929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZUDENKO",
        "first_name": "ARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TKID",
            "identifier": "100074753",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Azudenk000@citymail.cuny.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1 Brookdale Plz",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112123139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "azudenk000@citymail.cuny.edu",
            "affiliation": "N",
            "address_1": "606 W 57th St Apt 2001",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100191394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.