Individual provider Active NPI

Yana Maksumova

  • Speech-Language Pathologist
  • South Richmond Hill, NY
National Provider Identifier
1740582147
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
016185-1 Issued in NY
Practice address
11515 101St Ave
South Richmond Hill, NY 11419-1247
Phone
(718) 441-5333
NPI assigned
Nov 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 016185-1 NY Primary

Addresses

Primary practice location

11515 101St Ave
South Richmond Hill, NY 11419-1247

Mailing address

14069 Burden Cres
Briarwood, NY 11435-2322
Phone (718) 291-3671

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

State licenses

LicenseStateTypeSpecialty
016185-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Heartshare Past Accepting new patients

Organizations & group practices 1

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": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1740582147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14069 BURDEN CRES",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114352322",
            "telephone_number": "718-291-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 101ST AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191247",
            "telephone_number": "718-441-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKSUMOVA",
        "first_name": "YANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016185-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; 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.