Individual provider Active NPI

Aleksandr V. Yultyev, M.D.

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1700128394
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME133969 Issued in FL
Practice address
375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone
(513) 862-3229
NPI assigned
Mar 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0057177 CO
Internal Medicine Physician 207R00000X ME133969 FL Primary

Addresses

Primary practice location

375 Dixmyth Ave
Cincinnati, OH 45220-2475

Mailing address

5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (877) 832-2652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200616003545 FL Practitioner - Internal MedicinePractitioner - Hospitalist 6608187398 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coral Springs Physician Services, LLCGroup PAC ID 7719268333, 36 clinicians

Practice addresses (Care Compare)

3000 Coral Hills Dr
Coral Springs, FL 33065-4108
Phone (954) 344-3000

Hospital & facility affiliations

  • Trust USA Home Health LLC Home health agency, Plantation, FL, CCN 109594
  • Broward Health Coral Springs Hospital, Coral Springs, FL, CCN 100276

Merit-based Incentive Payment System (MIPS)

Final score
92.99 of 100Reported as group
Quality
82.79
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coral Springs Physician Services, LLC CurrentSince May 27, 2020 Accepting new patients
Fort Lauderdale Physician Services, LLC CurrentSince Oct 12, 2021 Accepting new patients
HHA Associates LLC CurrentSince Oct 1, 2021 Accepting new patients

Locations

6401 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 776-8500

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

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 2

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1700128394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 S CONGRESS AVE",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621149",
            "telephone_number": "877-832-2652",
            "fax_number": "800-792-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 DIXMYTH AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202475",
            "telephone_number": "513-862-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YULTYEV",
        "first_name": "ALEKSANDR",
        "middle_name": "V.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0057177",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME133969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.