Individual provider Active NPI

Irina Yadov, APRN, FNP-C

  • Family Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1861275695
Registry record updated Jan 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ14898900 Issued in NJ
Practice address
20 Prospect Ave Ste 801
Hackensack, NJ 07601-1963
Phone
(973) 343-6676
NPI assigned
Aug 15, 2023
Last updated
Jan 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ14898900 NJ Primary

Addresses

Primary practice location

20 Prospect Ave Ste 801
Hackensack, NJ 07601-1963

Mailing address

20 Prospect Ave Ste 801
Hackensack, NJ 07601-1963
Phone (201) 343-6676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231117000350 NJ Practitioner - Nurse Practitioner 7517314263 Reassigns benefits to 1 organization
I20240619001268 NY Practitioner - Nurse Practitioner 7517314263 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Epilepsy & Neurophysiology Medical Consultants PA CurrentSince Oct 24, 2023 Accepting new patients
Epilepsy & Neurophysiology Medical Consultants, PA Family CurrentSince Oct 24, 2023 Accepting new patients
Epilepsy & Neurophysiology Medical Consulting PC CurrentSince May 7, 2024 Accepting new patients

Locations

20 Prospect Ave
Ste 800
Hackensack, NJ 07601
Phone (201) 343-6676

20 Prospect Ave
Ste 801
Hackensack, NJ 07601
Phone (201) 488-8440

200 S Orange Ave
Ste 275
Livingston, NJ 07039
Phone (732) 235-6333

2 Capital Way
Fl 2
Pennington, NJ 08534
Phone (908) 522-4990

390 Crystal Run Rd
Ste 102
Middletown, NY 10941
Phone (845) 692-8780

737 Castleton Ave
Staten Island, NY 10310
Phone (718) 655-6595

333 Westchester Ave
Ste E104
White Plains, NY 10604
Phone (914) 428-9213

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704499200000",
    "number": "1861275695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 801",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011963",
            "telephone_number": "201-343-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 801",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011963",
            "telephone_number": "973-343-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADOV",
        "first_name": "IRINA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2024-01-06",
        "certification_date": "2023-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14898900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.