Individual provider Active NPI

Andriy Yuryev, M.D.

  • Psychiatry Physician
  • Tequesta, FL
National Provider Identifier
1649527755
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME132197 Issued in FL
Practice address
11301 SE Tequesta Ter
Tequesta, FL 33469
Phone
(561) 744-0211
NPI assigned
Aug 8, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME132197 FL Primary

Addresses

Primary practice location

11301 SE Tequesta Ter
Tequesta, FL 33469

Mailing address

11301 SE Tequesta Ter
Tequesta, FL 33469-8146
Phone (561) 744-0211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, PA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20211103000903 NY Practitioner - Psychiatry 9234527730 Reassigns benefits to 2 organizations
I20211119000473 FL Practitioner - Psychiatry 9234527730 Reassigns benefits to 1 organization
I20211119000475 PA Practitioner - Psychiatry 9234527730 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME132197FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Psychiatry CurrentSince Oct 1, 2021 Accepting new patients
Che Behavioral Health Services of Florida, P.a. Psychiatry CurrentSince Sep 1, 2021 Accepting new patients
Knapp Street Psychiatry, PC Psychiatry CurrentSince Oct 1, 2021 Accepting new patients
Che Senior Care Therapy Services PC Psychiatry CurrentSince Oct 1, 2021 Accepting new patients
SP Behavioral LLC Past Accepting new patients

Locations

6750 N Andrews Ave
Ste 200
Lauderdale Lakes, FL 33309
Phone (718) 408-5477

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

208 Fernbrook Ave
Wyncote, PA 19095
Phone (610) 668-8553

Organizations & group practices 5

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": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649527755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 SE TEQUESTA TER",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334698146",
            "telephone_number": "561-744-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 SE TEQUESTA TER",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "33469",
            "telephone_number": "561-744-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YURYEV",
        "first_name": "ANDRIY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME132197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tequesta, FL

Sources for this page

Verify at the official NPI Registry.