Individual provider Active NPI

Anastasiya B Skorobogatova, WHNP

  • Women's Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1740833375
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
421392 Issued in NY
Practice address
620 Reiss PL Apt 6K
Bronx, NY 10467-8062
Phone
(917) 573-7789
NPI assigned
Jul 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 421392 NY Primary

Addresses

Primary practice location

620 Reiss PL Apt 6K
Bronx, NY 10467-8062

Mailing address

620 Reiss PL Apt 6K
Bronx, NY 10467-8062
Phone (917) 573-7789

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Bronx

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
I20191217000249 NY Practitioner - Nurse Practitioner 8426482969 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
421392NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Barnabas OB GYN, PC CurrentSince May 1, 2022 Accepting new patients

Locations

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

Interoperability endpoints

  • Direct secure messaging: askorobogatova18721@sbhny.direct-ci.net

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": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1740833375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 REISS PL APT 6K",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104678062",
            "telephone_number": "917-573-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 REISS PL APT 6K",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104678062",
            "telephone_number": "917-573-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOROBOGATOVA",
        "first_name": "ANASTASIYA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "WHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "421392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Bronx",
            "affiliation": "N",
            "address_1": "620 Reiss Pl Apt 6K",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104678062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.