Arkady Yusupov, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

29290201 Issued in NY

Practice address

1700 Great Neck Rd
Copiague, NY 11726-2723

Phone

(347) 624-3341

NPI assigned

Oct 23, 2014

Last updated

Sep 2, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sonoma Medical P.C.

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  • Brentwood, NY
  • NPI 1770198871
  Authorized official Same address or phone

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1497150148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 GREAT NECK RD",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117262723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 GREAT NECK RD",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117262723",
            "telephone_number": "347-624-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSUPOV",
        "first_name": "ARKADY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-23",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "29290201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Wirth
• Christine Ann Woodson, RN
• Rebecca Wright
• WWW.Makinithealthy.Com (Makinithealthy)
• Deborah Young, PTA
• Carolynn Zalesak
• Christopher Zeoli, NPP
• Johann Zephirin, PA

• Neurology Physician in Copiague, NY
• Providers in Copiague, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.