Individual provider Active NPI

Grozdena Nikolova Yilmaz, PA

  • Surgical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1639396138
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0095540 Issued in NY
Practice address
339 Hicks St
Brooklyn, NY 11201-5509
Phone
(718) 780-1000
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0095540 NY Primary

Addresses

Primary practice location

339 Hicks St
Brooklyn, NY 11201-5509

Mailing address

370 Ocean Pkwy
Apt 4 K
Brooklyn, NY 11218-4655
Phone (347) 350-9433

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
I20150722004697 NY Practitioner - Physician Assistant 6103139944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1810 Voorhies Ave
Brooklyn, NY 11235-3312
Phone (347) 605-5740

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0095540NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island College Hospital Past Accepting new patients

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639396138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 OCEAN PKWY",
            "address_2": "APT 4 K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184655",
            "telephone_number": "347-350-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 HICKS ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015509",
            "telephone_number": "718-780-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YILMAZ",
        "first_name": "GROZDENA",
        "middle_name": "NIKOLOVA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "0095540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.