Individual provider Active NPI

Diana Yakubova, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1649870528
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F406659-01 Issued in NY
Practice address
80 5TH Ave
New York, NY 10011
Phone
(347) 707-7735
NPI assigned
Oct 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F406659-01 NY Primary
Adult Health Nurse Practitioner 363LA2200X 309948 NJ

Addresses

Primary practice location

80 5TH Ave
New York, NY 10011

Mailing address

200 Trenton Rd
Browns Mills, NJ 08015-1705

Other practice location 1

200 Trenton Rd
Browns Mills, NJ 08015-1705
Phone (347) 504-4826

Other names 1

  • Miss Diana Yakubova Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20260604000089 NJ Practitioner - Nurse Practitioner 0648741397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Service Fund of Deborah Heart and Lung CenterGroup PAC ID 4284537499, 118 clinicians

Practice addresses (Care Compare)

200 Trenton Rd
Browns Mills, NJ 08015-1705
Phone (609) 893-6611

212 Trenton Rd
Browns Mills, NJ 08015-1705
Phone (609) 893-6611

Hospital & facility affiliations

  • Deborah Heart and Lung Center Hospital, Browns Mills, NJ, CCN 310031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
309948NJMDAdult Health Nurse Practitioner
F406659-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orenda Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jun 25, 2026 Accepting new patients

Locations

80 5th Ave
Ste 90310
New York, NY 10011

80 5th Ave
New York, NY 10011
Phone (646) 460-0097

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1649870528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TRENTON RD",
            "city": "BROWNS MILLS",
            "state": "NJ",
            "postal_code": "080151705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011",
            "telephone_number": "347-707-7735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Trenton Rd",
            "address_purpose": "LOCATION",
            "city": "Browns Mills",
            "state": "NJ",
            "postal_code": "080151705",
            "country_code": "US",
            "telephone_number": "347-504-4826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAKUBOVA",
        "first_name": "DIANA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F406659-01",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "309948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "YAKUBOVA",
            "prefix": "MISS",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.