Individual provider Active NPI

Aliona Yezhova, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1588177802
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0103631 Issued in NJ
Practice address
930 E Tremont Ave
Bronx, NY 10460-4363
Phone
(718) 860-1111
Fax
(646) 224-1320
NPI assigned
Nov 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0103631 NJ Primary

Addresses

Primary practice location

930 E Tremont Ave
Bronx, NY 10460-4363

Mailing address

930 E Tremont Ave
Bronx, NY 10460-4363
Phone (718) 860-1111

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251126002964 NY Practitioner - Physician Assistant 8123510070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0103631NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brookview Medical Associates, PLLC CurrentSince Nov 1, 2025 Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

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": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1588177802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604363",
            "telephone_number": "718-860-1111",
            "fax_number": "646-224-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604363",
            "telephone_number": "718-860-1111",
            "fax_number": "646-224-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEZHOVA",
        "first_name": "ALIONA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "0103631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.