Individual provider Active NPI

Yanina Kostina, M.D.

  • Neuro-ophthalmology Physician
  • Waterbury, CT
National Provider Identifier
1669442687
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuro-ophthalmology PhysicianTaxonomy code 207WX0109X
License
038708 Issued in CT
Practice address
1201 W Main St
Suite 100
Waterbury, CT 06708-3105
Phone
(203) 597-9100
Fax
(203) 596-4758
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 038708 CT
Neuro-ophthalmology Physician 207WX0109X 038708 CT Primary

Addresses

Primary practice location

1201 W Main St
Suite 100
Waterbury, CT 06708-3105

Mailing address

1201 W Main St
Suite 100
Waterbury, CT 06708-3105
Phone (203) 597-9100

Other identifiers 1

IdentifierTypeStateIssuer
180000891OtherCTMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ykostina@tecg.intellechartdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20101117000209 CT Practitioner - Ophthalmology 0345374302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Eye Care Group, P.C.Group PAC ID 6103876628, 16 clinicians

Practice addresses (Care Compare)

6 Business Park Dr
Suite 102
Branford, CT 06405-2988
Phone (203) 573-4849

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.49 of 100Reported as group
Quality
92.44
Promoting interoperability
100
Improvement activities
40
Cost
65.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
038708CTMDNeuro-ophthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Care Group Ophthalmology CurrentSince Aug 7, 2000 Accepting new patients
The Eye Care Group, P.C. Ophthalmology CurrentSince Aug 7, 2000 Accepting new patients
TDG Connecticut PLLC Past Accepting new patients

Locations

6 Business Park Dr
Ste 102
Branford, CT 06405
Phone (203) 573-4849

250 Indian River Rd
Orange, CT 06477
Phone (203) 573-4849

250 Indian River Rd
Ste 100
Orange, CT 06477
Phone (203) 401-6378

22 Old Waterbury Rd
Ste 202
Southbury, CT 06488
Phone (203) 262-1600

1201 W Main St
Ste 100
Waterbury, CT 06708
Phone (203) 573-4849

Interoperability endpoints

  • Direct secure messaging: ykostinaoneil@direct.wtbyhosp.org
  • Direct secure messaging: yanina.kostina.p1@direct.theeyecaregroup.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1669442687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W MAIN ST",
            "address_2": "SUITE 100",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083105",
            "telephone_number": "203-597-9100",
            "fax_number": "203-401-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W MAIN ST",
            "address_2": "SUITE 100",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083105",
            "telephone_number": "203-597-9100",
            "fax_number": "203-596-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTINA",
        "first_name": "YANINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "038708",
            "primary": false
        },
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "CT",
            "license": "038708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "180000891",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ykostina@tecg.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "1201 W Main St",
            "address_2": "Suite 100",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067083105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.