Individual provider Active NPI

Aksana M. Suleymanov

  • Physician Assistant
  • New York, NY
National Provider Identifier
1730316316
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013236 Issued in NY
Practice address
VA Ny Harbor Healthcare System
423 E 23Rd St
New York, NY 10010
Phone
(212) 686-7500
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013236 NY Primary

Addresses

Primary practice location

VA Ny Harbor Healthcare System
423 E 23Rd St
New York, NY 10010

Mailing address

7502 169TH St
Fresh Meadows, NY 11366-1338
Phone (917) 293-2661

Other names 1

  • Mrs. Aksana Suleymanov Former name

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210329000411 NY Practitioner - Physician Assistant 1658788286 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013236NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Lij, Urgent Care, P.C. CurrentSince Dec 6, 2025 Accepting new patients

Locations

5828 99th St
Flushing, NY 11368
Phone (718) 502-9867

1240 Ulster Ave
Kingston, NY 12401
Phone (845) 443-8720

377 S Oyster Bay Rd
Plainview, NY 11803
Phone (516) 537-9061

9881 Queens Blvd
Rego Park, NY 11374
Phone (718) 502-9798

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: aksana.suleymanov@ghuc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1730316316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7502 169TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661338",
            "telephone_number": "917-293-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA NY HARBOR HEALTHCARE SYSTEM",
            "address_2": "423 E 23RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "212-686-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULEYMANOV",
        "first_name": "AKSANA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AKSANA",
            "last_name": "SULEYMANOV",
            "prefix": "MRS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.