Individual provider Active NPI

Esya Yusupova

  • Specialist
  • Middle Village, NY
National Provider Identifier
1962807818
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
8441 63Rd Rd
Middle Village, NY 11379-1947
Phone
(917) 495-2532
NPI assigned
Nov 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

8441 63Rd Rd
Middle Village, NY 11379-1947

Mailing address

8441 63Rd Rd
Middle Village, NY 11379-1947
Phone (917) 495-2532

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bolzano Group LLC Specialist Current Accepting new patients

Organizations & group practices 1

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": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1962807818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8441 63RD RD",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791947",
            "telephone_number": "917-495-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8441 63RD RD",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791947",
            "telephone_number": "917-495-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSUPOVA",
        "first_name": "ESYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.