Active NPI
Igor Yatsyuk, NP
- Nurse Practitioner
- Baldwinsville, NY
National Provider Identifier
1790661239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- F357185-01
- Practice address
- 7905 Glenbrook Dr
Baldwinsville, NY 13027-9492 - Phone
- (315) 720-4335
- NPI assigned
- Aug 12, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F357185-01 | NY | Primary |
Addresses
Primary practice location
7905 Glenbrook Dr
Baldwinsville, NY 13027-9492
Mailing address
7905 Glenbrook Dr
Baldwinsville, NY 13027-9492
Phone (315) 720-4335
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F357185-01 | NY | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754956800000",
"number": "1790661239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7905 GLENBROOK DR",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130279492",
"telephone_number": "315-720-4335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7905 GLENBROOK DR",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130279492",
"telephone_number": "315-720-4335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YATSYUK",
"first_name": "IGOR",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-08-12",
"last_updated": "2025-08-12",
"certification_date": "2025-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "F357185-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baldwinsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.