Individual provider Active NPI

Lydmila Serebryany, RPA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1932274701
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008581 Issued in NY
Practice address
80 Avenue P
Apt #13
Brooklyn, NY 11204-6101
Phone
(718) 232-3507
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 008581 NY Primary

Addresses

Primary practice location

80 Avenue P
Apt #13
Brooklyn, NY 11204-6101

Mailing address

80 Avenue P
Apt #13
Brooklyn, NY 11204-6101
Phone (718) 232-3507

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008581NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1932274701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 AVENUE P",
            "address_2": "APT #13",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112046101",
            "telephone_number": "718-232-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 AVENUE P",
            "address_2": "APT #13",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112046101",
            "telephone_number": "718-232-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEREBRYANY",
        "first_name": "LYDMILA",
        "name_prefix": "Mrs.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.