Individual provider Active NPI

Yelena Tsybulskiy, NP

  • Women's Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1770950347
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN2270350 Issued in MA
Practice address
Boston University - Occupational Health Center
930 Commonwealth Avenue Suite 1200
Boston, MA 02215
Phone
(617) 353-6630
Fax
(617) 353-6848
NPI assigned
Aug 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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 RN2270350 MA Primary

Addresses

Primary practice location

Boston University - Occupational Health Center
930 Commonwealth Avenue Suite 1200
Boston, MA 02215

Mailing address

Boston University - Occupational Health Center
930 Commonwealth Avenue Suite 1200
Boston, MA 02215
Phone (617) 353-6630

Other names 1

  • Ms. Yelena Gliks Former name

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2270350MAMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1440892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1770950347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOSTON UNIVERSITY - OCCUPATIONAL HEALTH CENTER",
            "address_2": "930 COMMONWEALTH AVENUE SUITE 1200",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-353-6630",
            "fax_number": "617-353-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BOSTON UNIVERSITY - OCCUPATIONAL HEALTH CENTER",
            "address_2": "930 COMMONWEALTH AVENUE SUITE 1200",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-353-6630",
            "fax_number": "617-353-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSYBULSKIY",
        "first_name": "YELENA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-30",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2270350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YELENA",
            "last_name": "GLIKS",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.