Individual provider Active NPI

Yana Grigoryeva, PA-C

  • Physician Assistant
  • Bridgeport, CT
National Provider Identifier
1942021621
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
126 Park Ave
Bridgeport, CT 06604-7620
Phone
(203) 576-2400
NPI assigned
Oct 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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 Primary

Addresses

Primary practice location

126 Park Ave
Bridgeport, CT 06604-7620

Mailing address

126 Park Ave
Bridgeport, CT 06604-7620
Phone (203) 576-2400

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251217000901 NY Practitioner - Physician Assistant 0840785911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

260 Ave X
Brooklyn, NY 11223-5940
Phone (718) 336-8855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
032988NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc CurrentSince Nov 1, 2025 Accepting new patients
Suny Downstate Medical Center PastSince Nov 1, 2025 Accepting new patients

Locations

770 Flatbush Ave
Brooklyn, NY 11226
Phone (347) 627-3988

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

200 Livingston St
Brooklyn, NY 11201
Phone (718) 522-3399

827 11th Ave
New York, NY 10019
Phone (212) 257-9778

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1942021621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 PARK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066047620",
            "telephone_number": "203-576-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 PARK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066047620",
            "telephone_number": "203-576-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGORYEVA",
        "first_name": "YANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.