Individual provider Active NPI

Oleg Yakubov, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1578897021
Registry record updated Jan 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62031631 Issued in NY
Practice address
263 7TH Ave Apt 2a
2A
Brooklyn, NY 11215-3693
Phone
(718) 369-8000
Fax
(718) 679-9381
NPI assigned
Sep 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 62031631 NY Primary

Addresses

Primary practice location

263 7TH Ave Apt 2a
2A
Brooklyn, NY 11215-3693

Mailing address

263 7TH Ave Apt 2a
2A
Brooklyn, NY 11215-3693
Phone (718) 369-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100114000513 NY Practitioner - Physical Therapist in Private Practice 1355483249 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62031631NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Rehabilitation Medicine P.C. CurrentSince May 13, 2018 Accepting new patients
Win Win PT PC Physical Therapist CurrentSince Aug 25, 2023 Accepting new patients

Locations

1660 E 14th St
Ste 101
Brooklyn, NY 11229
Phone (718) 375-0011

Organizations & group practices 2

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": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264204800000",
    "number": "1578897021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 7TH AVE APT 2A",
            "address_2": "2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153693",
            "telephone_number": "718-369-8000",
            "fax_number": "718-679-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 7TH AVE APT 2A",
            "address_2": "2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153693",
            "telephone_number": "718-369-8000",
            "fax_number": "718-679-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUBOV",
        "first_name": "OLEG",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-30",
        "last_updated": "2010-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "62031631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2010; 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.