Organization Active NPI

Pain Sedation Anesthesia PC

  • Anesthesiology Physician
  • Rego Park, NY
National Provider Identifier
1497406854
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PAIN SEDATION ANESTHESIA PC
Practice address
6240 Woodhaven Blvd Ste P17
Rego Park, NY 11374-3702
Phone
(718) 222-5999
Fax
(718) 387-6429
NPI assigned
Jan 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Yakub Abrakhimov, MDNPI 1144457698
Title
Ceo
Phone
(718) 222-5999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

6240 Woodhaven Blvd Ste P17
Rego Park, NY 11374-3702

Mailing address

9957 62ND Dr
Rego Park, NY 11374-1937
Phone (718) 222-5999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220321002317 NY Part B Supplier - Clinic/Group Practice 2163817503 Receives reassigned benefits from 4 practitioners
Practice locations: Rego Park, NY

National Provider Directory

National Provider Directory

Locations

6240 Woodhaven Blvd
Ste P17
Rego Park, NY 11374
Phone (718) 200-8846

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1497406854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9957 62ND DR",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741937",
            "telephone_number": "718-222-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 WOODHAVEN BLVD STE P17",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743702",
            "telephone_number": "718-222-5999",
            "fax_number": "718-387-6429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN SEDATION ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "ABRAKHIMOV",
        "authorized_official_first_name": "YAKUB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-222-5999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.