Individual provider Active NPI

Yuliya Boruch, CNM, NP, RN

  • Advanced Practice Midwife
  • New York, NY
National Provider Identifier
1619012242
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
001245 Issued in NY
Practice address
124 E 40TH St RM 203
New York, NY 10016
Phone
(877) 963-9777
Fax
(877) 989-6644
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 360473 NY
Advanced Practice Midwife 367A00000X 25ME00041900 NJ
Advanced Practice Midwife 367A00000X 001245 NY Primary
Registered Nurse 163W00000X 521535 NY

Addresses

Primary practice location

124 E 40TH St RM 203
New York, NY 10016

Mailing address

18222 Tudor Rd
Jamaica, NY 11432-1510

Other practice location 1

1036 Park Ave
suite 1 B
New York, NY 10028-0971
Phone (877) 963-9777

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110919000608 NY Practitioner - Certified Nurse Midwife (CNM) 5991976243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

124 E 40TH St
RM 203
New York, NY 10016-1763
Phone (877) 963-9777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
001245NYMDMental Health Counselor
521535NYMDRegistered Nurse
360473NYMDObstetrics & Gynecology Nurse Practitioner
25ME00041900NJMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Boruch Midwifery P.C. CurrentSince Mar 19, 2012 Accepting new patients

Locations

4711 Church Ave
Brooklyn, NY 11203
Phone (347) 915-2131

124 E 40th St
Rm 203
New York, NY 10016
Phone (718) 938-4488

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1619012242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18222 TUDOR RD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E 40TH ST RM 203",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "877-963-9777",
            "fax_number": "877-989-6644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1036 Park Ave",
            "address_2": "suite 1 B",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100280971",
            "country_code": "US",
            "telephone_number": "877-963-9777",
            "fax_number": "877-989-6644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORUCH",
        "first_name": "YULIYA",
        "name_prefix": "Mrs.",
        "credential": "CNM, NP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "360473",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00041900",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "001245",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "521535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.