Soloman Yagudayev, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F308097 Issued in NY

Practice address

77 N Centre Ave Ste 208
Rockville Centre, NY 11570-3923

Phone

(212) 319-1339

NPI assigned

Jul 25, 2017

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

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  Medicare reassignment NPD
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  NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1578086211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13526 78TH AVE APT F",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N CENTRE AVE STE 208",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703923",
            "telephone_number": "212-319-1339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13526 78TH AVE",
            "address_2": "APT F",
            "address_purpose": "LOCATION",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11367",
            "country_code": "US",
            "telephone_number": "718-451-6634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7224 Kissena Blvd # 1",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113672729",
            "country_code": "US",
            "telephone_number": "718-576-4652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAGUDAYEV",
        "first_name": "SOLOMAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-25",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F308097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Wong, CNIM
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• Minglu Yan, L.AC
• Margaret S Yang-Machado, FNP-C
• Chin Tsun Yang, M.D.

• Adult Health Nurse Practitioner in Rockville Centre, NY
• Providers in Rockville Centre, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.