Individual provider Active NPI

Mikhail Yakubov, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Flushing, NY
National Provider Identifier
1861662496
Registry record updated May 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
246668 Issued in NY
Practice address
5719 157TH St
Flushing, NY 11355-5518
Phone
(718) 463-6467
NPI assigned
Mar 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2024

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X C2-0011981 DE
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 269216 MA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X DO00841 RI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X OS018620 PA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MB10036300 NJ
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 246668 NY Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X DO2661 ME
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 55791 CT
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 34.012471 OH
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 032.0122521 VT
Endocrinology, Diabetes & Metabolism Physician 207RE0101X H82229 MD
Endocrinology, Diabetes & Metabolism Physician 207RE0101X E-16970 AR
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2819-321 WI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 5101022873 MI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 02004914A IN

Addresses

Primary practice location

5719 157TH St
Flushing, NY 11355-5518

Mailing address

5719 157TH St
Flushing, NY 11355-5518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ME2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090116000002 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 1557424660 Reassigns benefits to 5 organizations
I20251204004137 ME Practitioner - Internal Medicine 1557424660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wyckoff Professional Medical Services PCGroup PAC ID 6406748607, 154 clinicians
Mikhail Yakubov DO PLLCGroup PAC ID 2769822733, 3 clinicians

Practice addresses (Care Compare)

1155 Northern Blvd
Manhasset, NY 11030-3040
Phone (516) 390-2850

374 Stockholm St
Brooklyn, NY 11237-4006
Phone (718) 963-7266

7915 Metropolitan Ave
Middle Village, NY 11379-2930
Phone (718) 973-1199

Hospital & facility affiliations

  • Wyckoff Heights Medical Center Hospital, Brooklyn, NY, CCN 330221
  • Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E-16970ARMDEndocrinology, Diabetes & Metabolism Physician
55791CTMDEndocrinology, Diabetes & Metabolism Physician
C2-0011981DEMDEndocrinology, Diabetes & Metabolism Physician
02004914AINMDEndocrinology, Diabetes & Metabolism Physician
269216MAMDEndocrinology, Diabetes & Metabolism Physician
H82229MDMDEndocrinology, Diabetes & Metabolism Physician
DO2661MEMDEndocrinology, Diabetes & Metabolism Physician
5101022873MIMDEndocrinology, Diabetes & Metabolism Physician
25MB10036300NJMDEndocrinology, Diabetes & Metabolism Physician
246668NYMDEndocrinology, Diabetes & Metabolism Physician
34.012471OHMDEndocrinology, Diabetes & Metabolism Physician
OS018620PAMDEndocrinology, Diabetes & Metabolism Physician
DO00841RIMDEndocrinology, Diabetes & Metabolism Physician
032.0122521VTMDEndocrinology, Diabetes & Metabolism Physician
2819-321WIMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor on Demand Professionals P C CurrentSince Sep 26, 2023 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Jan 8, 2013 Accepting new patients
Mikhail Yakubov, D.O., PLLC Endocrinology, Diabetes & Metabolism CurrentSince Mar 16, 2024 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Internal Medicine CurrentSince Oct 14, 2019 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Internal Medicine CurrentSince Oct 14, 2019 Accepting new patients
Wyckoff Professional Medical Services, PC Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Jan 8, 2013 Accepting new patients
New York University Past Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

45 Memorial Cir
Augusta, ME 04330
Phone (855) 270-3624

80 State St
Albany, NY 12207
Phone (415) 742-8411

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

2 Glenmere Cove Rd
Goshen, NY 10924
Phone (845) 291-4700

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

1155 Northern Blvd
Manhasset, NY 11030
Phone (516) 407-4000

7915 Metropolitan Ave
Middle Vlg, NY 11379
Phone (516) 806-2544

6135 Dry Harbor Rd
Middle Vlg, NY 11379
Phone (718) 505-7500

Networks

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

Interoperability endpoints

  • Direct secure messaging: mikhail.yakubov.1@30520.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715472000000",
    "number": "1861662496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5719 157TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5719 157TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555518",
            "telephone_number": "718-463-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUBOV",
        "first_name": "MIKHAIL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-11",
        "last_updated": "2024-05-12",
        "certification_date": "2023-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "DE",
            "license": "C2-0011981",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MA",
            "license": "269216",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "RI",
            "license": "DO00841",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "OS018620",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MB10036300",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "246668",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "ME",
            "license": "DO2661",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "55791",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OH",
            "license": "34.012471",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VT",
            "license": "032.0122521",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MD",
            "license": "H82229",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AR",
            "license": "E-16970",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "WI",
            "license": "2819-321",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "5101022873",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IN",
            "license": "02004914A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.