Individual provider Active NPI

Lyudmila Timofeyeva, RN

  • Registered Nurse
  • Forest Hills, NY
National Provider Identifier
1720601537
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
649246-01 Issued in NY
Practice address
11215 72ND Rd Ste LL1
Forest Hills, NY 11375-4600
Phone
(718) 261-3437
Fax
(718) 261-4142
NPI assigned
May 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 649246-01 NY Primary

Addresses

Primary practice location

11215 72ND Rd Ste LL1
Forest Hills, NY 11375-4600

Mailing address

11215 72ND Rd Ste LL1
Forest Hills, NY 11375-4600
Phone (718) 261-3437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
649246-01NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1720601537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 72ND RD STE LL1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754600",
            "telephone_number": "718-261-3437",
            "fax_number": "718-261-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 72ND RD STE LL1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754600",
            "telephone_number": "718-261-3437",
            "fax_number": "718-261-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMOFEYEVA",
        "first_name": "LYUDMILA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "649246-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.