Active NPI
Olga Yakobov
- Physician Assistant
- Flushing, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 016764-1
- Practice address
- 5645 Main St
W-LL 300
Flushing, NY 11355-5045 - Phone
- (718) 445-0220
- Fax
- (718) 661-7405
- NPI assigned
- Aug 29, 2013
- Last updated
- Jan 24, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 016764-1 | NY | Primary |
Addresses
Primary practice location
5645 Main St
W-LL 300
Flushing, NY 11355-5045
Mailing address
5645 Main St
W-LL 300
Flushing, NY 11355-5045
Phone (718) 445-0220
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | oly9001@direct.nyp.org | Direct | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11205 A Queens Blvd
Forest Hills, NY 11375-8311
Phone (718) 303-3725
11205 Queens Blvd
Forest Hills, NY 11375-8311
16303 Horace Harding Expy
Fresh Meadows, NY 11365-1449
18603 Union Tpke
Flushing, NY 11366-1733
Phone (718) 670-1837
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 85.32
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016764-1 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York Queens Medicine and Surgery, P.C. | Current | Accepting new patients | |
| Fpa Hospital Based | Current | Accepting new patients | |
| Nes Medical Services of New York PC | Current | Accepting new patients | |
| Fpa Hospital Based | Current | Accepting new patients | |
| Bimc Faculty Practice | Physician Assistant | Past | Accepting new patients |
Locations
150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123
5645 Main St
#300
Flushing, NY 11355
Phone (718) 303-3720
16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121
18603 Union Tpke
Fresh Meadows, NY 11366
Phone (718) 670-1837
455 E Bay Dr
Long Beach, NY 11561
Phone (516) 432-8000
1000 10th Ave
New York, NY 10019
Phone (212) 523-2369
1176 5th Ave
New York, NY 10029
Phone (212) 241-6237
1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- oly9001@direct.nyp.org
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Newyork-Presbyterian Medical Group/Queens
- Pediatrics Physician
- Fresh Meadows, NY
- NPI 1003114851
-
- Nuclear Medicine Physician
- New York, NY
- NPI 1629319413
-
dba FPA Hospital Based MSMC Emergency Physicians
- Emergency Medicine Physician
- New York, NY
- NPI 1427398676
-
dba Mount Sinai Dermatopathology Services III
- Dermatopathology (Pathology) Physician
- New York, NY
- NPI 1841531795
-
- Emergency Medicine Physician
- Elmira, NY
- NPI 1831742816
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba NYP-Queens Diagnostic Lab
- Clinical Medical Laboratory
- Flushing, NY
- NPI 1053429274
Hospital
-
dba Transitional Care Unit
- Skilled Nursing Facility
- Flushing, NY
- NPI 1689958779
Hospital
-
- General Acute Care Hospital
- Flushing, NY
- NPI 1952347205
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706054400000",
"number": "1740614445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5645 MAIN ST",
"address_2": "W-LL 300",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113555045",
"telephone_number": "718-445-0220",
"fax_number": "718-661-7405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5645 MAIN ST",
"address_2": "W-LL 300",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113555045",
"telephone_number": "718-445-0220",
"fax_number": "718-661-7405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAKOBOV",
"first_name": "OLGA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-29",
"last_updated": "2024-01-24",
"certification_date": "2024-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "016764-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "oly9001@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "direct address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "direct address",
"address_1": "18603 Union Tpke",
"city": "Fresh Meadows",
"state": "NY",
"country_code": "US",
"postal_code": "113661733",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "18603 Union Tpke",
"city": "Fresh Meadows",
"state": "NY",
"country_code": "US",
"postal_code": "113661733",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "18603 Union Tpke",
"city": "Fresh Meadows",
"state": "NY",
"country_code": "US",
"postal_code": "113661733",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.