Organization Active NPI

Yd Podiatry, PC

  • Podiatrist
  • Bronx, NY
National Provider Identifier
1720155377
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
005747 Issued in NY
Legal business name
YD PODIATRY, PC
Practice address
2440 Hunter Ave
Apt 6B
Bronx, NY 10475-5646
Phone
(718) 708-6121
Fax
(718) 708-5381
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Authorized official

Name
Yelena Dreyzina, DPMNPI 1134127632
Title
Director
Phone
(718) 708-6121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 005747 NY Primary

Addresses

Primary practice location

2440 Hunter Ave
Apt 6B
Bronx, NY 10475-5646

Mailing address

2440 Hunter Ave
Apt 6B
Bronx, NY 10475-5646
Phone (718) 708-6121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040507000010 NY Part B Supplier - Clinic/Group Practice 5799774626 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1720155377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 HUNTER AVE",
            "address_2": "APT 6B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104755646",
            "telephone_number": "718-708-6121",
            "fax_number": "718-708-5381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 HUNTER AVE",
            "address_2": "APT 6B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104755646",
            "telephone_number": "718-708-6121",
            "fax_number": "718-708-5381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YD PODIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "DREYZINA",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-708-6121",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "005747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.