Active NPI
Lev Yakubov, PA
- Surgical Physician Assistant
- Flushing, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- '010126
- Practice address
- 56-45 Main Street
CRT Surgical Associates, PC
Flushing, NY 11355-5045 - Phone
- (718) 445-0220
- Fax
- (718) 939-1167
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 010126 | NY | |
| Surgical Physician Assistant | 363AS0400X | '010126 | NY | Primary |
Addresses
Primary practice location
56-45 Main Street
CRT Surgical Associates, PC
Flushing, NY 11355-5045
Mailing address
56-45 Main Street
CRT Surgical Associates, PC
Flushing, NY 11355-5045
Phone (718) 445-0220
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Direct | |
| Direct Messaging Address | CWID@direct.nyp.org | Direct | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010126 | NY | MD | Mental Health Counselor |
| '010126 | NY | MD | Surgical Physician Assistant |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York Queens Medicine and Surgery, P.C. | Current | Accepting new patients | |
| Excel Medical PC | Current | Accepting new patients |
Locations
5645 Main St
Flushing, NY 11355
Phone (718) 670-1435
5620 Main St
Flushing, NY 11355
Phone (718) 670-1837
16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121
6711 164th St
Fresh Meadows, NY 11365
Phone (718) 762-4500
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
Organizations & group practices 4
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.
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- Family Medicine Physician
- Flushing, NY
- NPI 1003005083
-
- Pediatrics Physician
- Fresh Meadows, NY
- NPI 1003114851
-
- Internal Medicine Physician
- Forest Hills, NY
- NPI 1760731459
-
- Internal Medicine Physician
- Fresh Meadows, NY
- NPI 1659906667
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668729600000",
"number": "1821032491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56-45 MAIN STREET",
"address_2": "CRT SURGICAL ASSOCIATES, PC",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113555045",
"telephone_number": "718-445-0220",
"fax_number": "718-939-1167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56-45 MAIN STREET",
"address_2": "CRT SURGICAL ASSOCIATES, PC",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113555045",
"telephone_number": "718-445-0220",
"fax_number": "718-939-1167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAKUBOV",
"first_name": "LEV",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2022-11-18",
"certification_date": "2022-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "010126",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "'010126",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "56-45 Main Street",
"address_2": "CRT Surgical Associates, PC",
"city": "Flushing",
"state": "NY",
"country_code": "US",
"postal_code": "113555045",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "CWID@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "Direct Access",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "56-45 Main Street",
"address_2": "CRT Surgical Associates, PC",
"city": "Flushing",
"state": "NY",
"country_code": "US",
"postal_code": "113555045",
"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": "56-45 Main Street",
"address_2": "CRT Surgical Associates, PC",
"city": "Flushing",
"state": "NY",
"country_code": "US",
"postal_code": "113555045",
"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 Nov 18, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.