Svyatoslav Bakis, LCSW

Primary specialty

Adult Development & Aging PsychologistTaxonomy code 103TA0700X

License

052698-1 Issued in NY

Practice address

745 64TH St
Brooklyn, NY 11220-4753

Phone

(718) 283-1913

Fax

(718) 635-6745

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710107735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 MALLORY AVE",
            "address_2": "B",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054200",
            "telephone_number": "718-876-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 64TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204753",
            "telephone_number": "718-283-1913",
            "fax_number": "718-635-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKIS",
        "first_name": "SVYATOSLAV",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "052698-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "052698-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatyana Bakhurets-Grasso, M.D
• Joana Bakiasi
• Bakir Altai MD
• Fotikhkhon Bakirhonov, MD
• Alexander Bakis, M.D.
• Ilhom Bakiyev, PA
• Christie Amanda Bakker
• Harun Bakla, MD
• Armand Baklajian
• Victoria Bakley

• Adult Development & Aging Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Adult Development & Aging Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.