Individual provider Active NPI

Yuliya Mitnitsky

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1629082474
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
010588 Issued in NY
Practice address
1 Prospect Park W
Suite C
Brooklyn, NY 11215-1601
Phone
(718) 230-7788
Fax
(718) 230-8017
NPI assigned
Jul 28, 2006
Last updated
Oct 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 010588 NY Primary

Addresses

Primary practice location

1 Prospect Park W
Suite C
Brooklyn, NY 11215-1601

Mailing address

1 Prospect Park W
Suite C
Brooklyn, NY 11215-1601
Phone (718) 230-7788

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
I20060921000567 NY Practitioner - Physician Assistant 0941205165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brighton Medical Care Ny PLLCGroup PAC ID 7810275377, 16 clinicians

Practice addresses (Care Compare)

1009 Brighton Beach Ave
Suite 2
Brooklyn, NY 11235-5621
Phone (718) 975-8500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: yuliyamitnitsky@mai.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1629082474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PROSPECT PARK W",
            "address_2": "SUITE C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112151601",
            "telephone_number": "718-230-7788",
            "fax_number": "718-230-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PROSPECT PARK W",
            "address_2": "SUITE C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112151601",
            "telephone_number": "718-230-7788",
            "fax_number": "718-230-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITNITSKY",
        "first_name": "YULIYA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "010588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.