Individual provider Active NPI

Viktor Yatsynovich, M.D.

  • Psychiatry Physician
  • Niagara Falls, NY
National Provider Identifier
1730323239
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
018014 Issued in ME
Practice address
621 10TH St
Niagara Falls, NY 14301-1813
Phone
(716) 278-4000
NPI assigned
Apr 28, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 018014 ME Primary

Addresses

Primary practice location

621 10TH St
Niagara Falls, NY 14301-1813

Mailing address

5165 Fox Trce
Williamsville, NY 14221-4166
Phone (416) 500-7553

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150313002149 NY Practitioner - Psychiatry 4486970266 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018014MEMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Niagara Falls Memorial Medical Center CurrentSince Apr 1, 2015 Accepting new patients
The Dale Association, Inc. CurrentSince Aug 11, 2020 Accepting new patients

Locations

33 Ontario St
Lockport, NY 14094
Phone (716) 433-1937

620 10th St
Ste 704
Niagara Falls, NY 14301
Phone (716) 278-4402

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1730323239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5165 FOX TRCE",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214166",
            "telephone_number": "416-500-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 10TH ST",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011813",
            "telephone_number": "716-278-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATSYNOVICH",
        "first_name": "VIKTOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-28",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "018014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

Verify at the official NPI Registry.