Individual provider Active NPI

Sofya B Yakutilova

  • Case Manager/Care Coordinator
  • Kew Gardens, NY
National Provider Identifier
1619560638
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
8511 Lefferts Blvd Apt 3F
Kew Gardens, NY 11415-3036
Phone
(347) 607-7528
NPI assigned
Feb 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

8511 Lefferts Blvd Apt 3F
Kew Gardens, NY 11415-3036

Mailing address

8511 Lefferts Blvd Apt 3F
Kew Gardens, NY 11415-3036
Phone (347) 607-7528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1619560638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8511 LEFFERTS BLVD APT 3F",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153036",
            "telephone_number": "347-607-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8511 LEFFERTS BLVD APT 3F",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153036",
            "telephone_number": "347-607-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUTILOVA",
        "first_name": "SOFYA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.