Individual provider Active NPI

Yana Shayayeva, O.T.

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1619264546
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
015383 Issued in NY
Practice address
150 55TH St
Brooklyn, NY 11220-2553
Phone
(718) 630-7425
Fax
(718) 630-7604
NPI assigned
Jun 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 015383 NY Primary

Addresses

Primary practice location

150 55TH St
Brooklyn, NY 11220-2553

Mailing address

5800 3Rd Ave
Brooklyn, NY 11220-3702
Phone (718) 630-6180

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190703000071 NY Practitioner - Occupational Therapist in Private Practice 1153655691 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab on Wheels OT PT PLLC CurrentSince May 19, 2019 Accepting new patients
Prokinetics Physical Therapy P.C. PastSince Jul 5, 2023 Accepting new patients

Locations

8419 Bay Pkwy
Brooklyn, NY 11214
Phone (718) 259-0199

174 Bay 29th St
Ste C1
Brooklyn, NY 11214
Phone (646) 750-4455

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": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1619264546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 3RD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203702",
            "telephone_number": "718-630-6180",
            "fax_number": "718-630-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202553",
            "telephone_number": "718-630-7425",
            "fax_number": "718-630-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYAYEVA",
        "first_name": "YANA",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "015383",
            "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 Jun 29, 2011; 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.