Individual provider Active NPI

Markiel Yakubov, O.D.

  • Optometrist
  • Kew Gardens, NY
National Provider Identifier
1881957249
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007877-1 Issued in NY
Practice address
105 81St Ave
Kew Gardens, NY 11415-1107
Phone
(347) 403-3877
NPI assigned
Jun 20, 2012
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007877-1 NY Primary

Addresses

Primary practice location

105 81St Ave
Kew Gardens, NY 11415-1107

Mailing address

105 81St Ave
Kew Gardens, NY 11415-1107
Phone (347) 403-3877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA, AR, OH, NH, VA, MI, MD8 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
I20120920000204 NY Practitioner - Optometry 1254589039 Reassigns benefits to 2 organizations
I20210901000347 MA Practitioner - Optometry 1254589039 Reassigns benefits to 2 organizations
I20211005003078 AR Practitioner - Optometry 1254589039 Reassigns benefits to 1 organization
I20211007002911 OH Practitioner - Optometry 1254589039 Reassigns benefits to 1 organization
I20220330001164 NH Practitioner - Optometry 1254589039 Reassigns benefits to 1 organization
I20220404000114 VA Practitioner - Optometry 1254589039 Reassigns benefits to 1 organization
I20220607000158 MI Practitioner - Optometry 1254589039 Reassigns benefits to 1 organization
I20240619000050 MD Practitioner - Optometry 1254589039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swift Optometry Care PCGroup PAC ID 9739321670, 8 clinicians

Practice addresses (Care Compare)

105 Landmark Dr
Stuart, VA 24171-9401
Phone (718) 534-0689

1975 White Dr
Batesville, AR 72501-9391
Phone (718) 534-0689

19840 Harper Ave
Harper Woods, MI 48225-1804
Phone (718) 534-0689

250 Skillman St
Brooklyn, NY 11205-1218

275 Moriches Rd
Saint James, NY 11780-2150
Phone (718) 963-3495

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007877-1NYMDOptometrist
007877NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chandler-Drakes Eyecare LLC Optometrist CurrentSince Aug 17, 2021 Accepting new patients
Chandler-Drakes Eyecare LLC Optometrist CurrentSince Aug 17, 2021 Accepting new patients
Family Optometry Care PC Optometrist Past Accepting new patients

Locations

111 Headwaters Dr
Harwich, MA 02645
Phone (508) 430-1717

393 Broadway
Brooklyn, NY 11211
Phone (516) 984-9692

Organizations & group practices 5

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1881957249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 81ST AVE",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151107",
            "telephone_number": "347-403-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 81ST AVE",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151107",
            "telephone_number": "347-403-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUBOV",
        "first_name": "MARKIEL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007877-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

Verify at the official NPI Registry.