Individual provider Active NPI

Yelena Yurchenko, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1700044922
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
044219 Issued in NY
Practice address
2101 Bay Ridge Pkwy # C
Brooklyn, NY 11204-5955
Phone
(718) 232-6996
Fax
(718) 232-6440
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 044219 NY Primary

Addresses

Primary practice location

2101 Bay Ridge Pkwy # C
Brooklyn, NY 11204-5955

Mailing address

2101 Bay Ridge Pkwy # C
Brooklyn, NY 11204-5955
Phone (718) 236-7676

Other identifiers 1

IdentifierTypeStateIssuer
01380203MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190408000611 NY Practitioner - Oral Surgery 4789982539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
New York University College of Dentistry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fusion Dental, P.C.Group PAC ID 4587997317, 3 clinicians

Practice addresses (Care Compare)

2101 Bay Ridge Pkwy
Brooklyn, NY 11204-5955
Phone (718) 232-6996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fusion Dental, P.C. CurrentSince Apr 9, 2019 Accepting new patients

Organizations & group practices 1

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1700044922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 BAY RIDGE PKWY # C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045955",
            "telephone_number": "718-236-7676",
            "fax_number": "718-236-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 BAY RIDGE PKWY # C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045955",
            "telephone_number": "718-232-6996",
            "fax_number": "718-232-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YURCHENKO",
        "first_name": "YELENA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "044219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01380203",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.