Active NPI
Elizabeth Yushuva, PA
- Physician Assistant
- Bronx, NY
National Provider Identifier
1477957785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 017934
- Practice address
- 1400 Pelham Pkwy S
Bronx, NY 10461-1138 - Phone
- (718) 918-5000
- NPI assigned
- Oct 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 017934 | NY | Primary |
Addresses
Primary practice location
1400 Pelham Pkwy S
Bronx, NY 10461-1138
Mailing address
6448 Booth St Apt 4E
Rego Park, NY 11374-4016
Phone (718) 737-6972
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017934 | NY | MD | Physician Assistant |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- eyushuva2035024@nychhc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1477957785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6448 BOOTH ST APT 4E",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113744016",
"telephone_number": "718-737-6972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PELHAM PKWY S",
"city": "BRONX",
"state": "NY",
"postal_code": "104611138",
"telephone_number": "718-918-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUSHUVA",
"first_name": "ELIZABETH",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-15",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "017934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.