Individual provider Active NPI

Yakov Nisimov, NP

  • Family Nurse Practitioner
  • Rego Park, NY
National Provider Identifier
1952183980
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
352558 Issued in NY
Practice address
6333 98TH PL Apt 3C
Rego Park, NY 11374-2317
Phone
(718) 415-5494
NPI assigned
Oct 16, 2023
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 352558 NY Primary

Addresses

Primary practice location

6333 98TH PL Apt 3C
Rego Park, NY 11374-2317

Mailing address

7925 150TH St Apt A20
Flushing, NY 11367-3803
Phone (718) 415-5494

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
I20231204001613 NY Practitioner - Nurse Practitioner 9133577034 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
WB Homecare Adulltand Family Health NP PLLCGroup PAC ID 8123389715, 6 clinicians

Practice addresses (Care Compare)

317 Maple Ave
Uniondale, NY 11553-1621
Phone (516) 286-1652

6333 98TH PL
Apt 3C
Rego Park, NY 11374-2317
Phone (718) 415-5494

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WB Homecare Adullt& Family Health NP PLLC CurrentSince Oct 30, 2023 Accepting new patients
Ny Family Health NP Services PC Family CurrentSince Feb 3, 2025 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1952183980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 150TH ST APT A20",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673803",
            "telephone_number": "718-415-5494",
            "fax_number": "866-728-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 98TH PL APT 3C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742317",
            "telephone_number": "718-415-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISIMOV",
        "first_name": "YAKOV",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-16",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.