Individual provider Active NPI

Antonina Yushuvayeva, MSED

  • Specialist
  • Fresh Meadows, NY
National Provider Identifier
1891058657
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
7150 160TH St # 1F
Fresh Meadows, NY 11365-4126
Phone
(646) 732-8319
NPI assigned
Jun 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NY
Specialist 174400000X NY Primary

Addresses

Primary practice location

7150 160TH St # 1F
Fresh Meadows, NY 11365-4126

Mailing address

7150 160TH St # 1F
Fresh Meadows, NY 11365-4126
Phone (646) 732-8319

Other identifiers 1

IdentifierTypeStateIssuer
1891058657OtherNYSPECIAL INSTRUCTOR TEACHER

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

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1891058657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 160TH ST # 1F",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654126",
            "telephone_number": "646-732-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 160TH ST # 1F",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654126",
            "telephone_number": "646-732-8319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSHUVAYEVA",
        "first_name": "ANTONINA",
        "credential": "MSED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIAL INSTRUCTOR TEACHER",
            "identifier": "1891058657",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.