Individual provider Active NPI

Yuriy Babadzhanov

  • Orthopedic Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1962947754
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
040334-1 Issued in NY
Practice address
2919 Avenue S
Brooklyn, NY 11229-2544
Phone
(347) 517-7654
NPI assigned
Jan 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 040334-1 NY Primary

Addresses

Primary practice location

2919 Avenue S
Brooklyn, NY 11229-2544

Mailing address

74 Sylvan PL
Valley Stream, NY 11581-1311
Phone (347) 517-7654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170328000406 NY Practitioner - Physical Therapist in Private Practice 5890070296 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Nest P.C.Group PAC ID 2567874985, 2 clinicians
Occupational Therapy Nest PLLCGroup PAC ID 4880091701, 2 clinicians

Practice addresses (Care Compare)

2919 Ave S
Brooklyn, NY 11229-2544
Phone (718) 554-3680

74 Sylvan PL
Valley Stream, NY 11581-1311

9508 Queens Blvd
Suite 1E
Rego Park, NY 11374-1151
Phone (718) 612-5634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040334-1NYMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Occupational Therapy Nest PLLC Orthopedic CurrentSince Aug 1, 2021 Accepting new patients
Physical Therapy Nest P.C. CurrentSince Oct 1, 2020 Accepting new patients
Refuah Physical Therapy, PC CurrentSince Feb 17, 2019 Accepting new patients

Locations

2919 Avenue S
Ste Ot
Brooklyn, NY 11229
Phone (718) 612-5634

2918 Avenue M
Brooklyn, NY 11210
Phone (718) 252-0625

5327 18th Ave
Brooklyn, NY 11204
Phone (718) 236-7707

2919 Avenue S
Brooklyn, NY 11229
Phone (347) 517-7654

9508 Queens Blvd
Ste 1E
Rego Park, NY 11374
Phone (718) 275-2669

Organizations & group practices 3

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": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1962947754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 SYLVAN PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811311",
            "telephone_number": "347-517-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 AVENUE S",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292544",
            "telephone_number": "347-517-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABADZHANOV",
        "first_name": "YURIY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-03",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "040334-1",
            "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 Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.