Individual provider Active NPI

Matvey Yagudayev, DPM

  • Foot & Ankle Surgery Podiatrist
  • Brooklyn, NY
National Provider Identifier
1588076806
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N006808 Issued in NY
Practice address
9920 4TH Ave Ste 109
Brooklyn, NY 11209-8379
Phone
(646) 339-4208
NPI assigned
May 21, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X N006808 NY Primary

Addresses

Primary practice location

9920 4TH Ave Ste 109
Brooklyn, NY 11209-8379

Mailing address

6625 103Rd St Apt 6F
Forest Hills, NY 11375-2020
Phone (646) 339-4208

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170629001624 NY Practitioner - Podiatry 8123397411 Reassigns benefits to 3 organizations
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Foot Care PCGroup PAC ID 0244454304, 3 clinicians

Practice addresses (Care Compare)

25062 Jericho Tpke
Floral Park, NY 11001-4004
Phone (718) 626-3338

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue74
Removal of skin lesions66
Removal of nail tissue119
Removal or shaving of skin growth57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006808NYMDCounselor
N006808NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Phase Two Podiatry PC CurrentSince Jul 18, 2017 Accepting new patients
Cross County Podiatry, PC Foot & Ankle Surgery CurrentSince Mar 7, 2021 Accepting new patients
Hamilton Podiatry P C Foot & Ankle Surgery CurrentSince Jan 28, 2018 Accepting new patients
Ideal Foot Care PC Foot & Ankle Surgery CurrentSince Sep 1, 2019 Accepting new patients
Maimonides Medical Center Current Accepting new patients

Locations

3116 30th Ave
Ste 203
Astoria, NY 11102
Phone (718) 545-3338

620 Sleepy Hollow Rd
Briarcliff Manor, NY 10510
Phone (800) 501-3936

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

9920 4th Ave
Ste 109
Brooklyn, NY 11209
Phone (718) 238-4305

25062 Jericho Tpke
Floral Park, NY 11001
Phone (646) 535-3668

301 Mill Rd
Ste U7
Hewlett, NY 11557

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: matveyyagudayev@mai.allscriptsdirect.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1588076806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 103RD ST APT 6F",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752020",
            "telephone_number": "646-339-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 4TH AVE STE 109",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112098379",
            "telephone_number": "646-339-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGUDAYEV",
        "first_name": "MATVEY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-21",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.