Eleanor Yusupov, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

247945 Issued in NY

Practice address

Northern Boulevard Academic Health Care Center
Nyit College of Osteopathic Medicine
Old Westbury, NY 11568-8000

Phone

(516) 686-3751

NPI assigned

Feb 12, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York Institute of TechnologyGroup PAC ID 3779496039, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: eleanor.yusupov@nyitahcc.eclinicaldirectplus.com

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.

• New York Institute of Technology

  • Family Medicine Physician
  • Old Westbury, NY
  • NPI 1821048612

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Nassau Health Care Corporation

  • General Acute Care Hospital
  • East Meadow, NY
  • NPI 1902822992
  Medicare reassignment NPD
• Nassau Health Care Corporation

  • General Acute Care Hospital
  • East Meadow, NY
  • NPI 1639194228
  NPD
• Nassau Health Care Corporation

  • General Acute Care Hospital
  • East Meadow, NY
  • NPI 1730530940
  NPD
• New York Institute of Technology

  • Family Medicine Physician
  • Central Islip, NY
  • NPI 1992738538
  NPD
• New York Institute of Technology

  • Family Medicine Physician
  • Jonesboro, AR
  • NPI 1760003248
  NPD
• St Francis Hospital United States Catholic Conference

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1750439030
  NPD (past)

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1891934923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8000",
            "address_2": "NORTHERN BOULEVARD, ACADEMIC HEALTH CARE CENTER",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115688000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTHERN BOULEVARD ACADEMIC HEALTH CARE CENTER",
            "address_2": "NYIT COLLEGE OF OSTEOPATHIC MEDICINE",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115688000",
            "telephone_number": "516-686-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSUPOV",
        "first_name": "ELEANOR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-12",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "247945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "247945",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ling Wan-Albert, OTR/L
• Westbury Ufsd
• Dorothee Adjehi Williams, CNA
• Jayne Debra Wolff, MA PT
• Sheldon C Yao, DO
• Hallie Y Zwibel, D.O.

• Internal Medicine Physician in Old Westbury, NY
• Providers in Old Westbury, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.