Steve Yusupov, DDS, MD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

057086 Issued in NY

Practice address

55 Bryant Ave
Roslyn, NY 11576-1139

Phone

(516) 749-3000

NPI assigned

Jul 5, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Steve Yusupov Former name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: syusupov67598@northwell.direct-ci.com
• Direct secure messaging: steveyusupov@mai.allscriptsdirect.net

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.

• Staten Island Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Staten Island, NY
  • NPI 1316217763
  Medicare reassignment NPD
• Gold Coast Oral & Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Roslyn, NY
  • NPI 1821738485
  NPD Authorized official
• Gold Coast Oral and Maxillofacial Surgery Syosset PLLC

  dba Gold Coast Oral and Maxillofacial Surgery

  • Ambulatory Surgical Clinic/Center
  • Syosset, NY
  • NPI 1922838432
  NPD Authorized official
• Same Day Smiles of Commack

  • Oral and Maxillofacial Surgery (Dentist)
  • Commack, NY
  • NPI 1154275923
  NPD Authorized official
• Sioms Forest Hills Management LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Forest Hills, NY
  • NPI 1124659479
  NPD (past) Authorized official
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• Am Dental Services P.C.

  dba The center for Implant Surgery

  • Dental Clinic/Center
  • Forest Hills, NY
  • NPI 1851163695
  NPD (past)

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982991485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256-C MASON AVENUE 3RD FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051851",
            "telephone_number": "718-226-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BRYANT AVE",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761139",
            "telephone_number": "516-749-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "451 Clarkson Ave",
            "address_2": "E Building, Department of Dentistry & Oral Maxillofacia",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032054",
            "country_code": "US",
            "telephone_number": "718-245-4914",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7009 Austin St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113751012",
            "country_code": "US",
            "telephone_number": "718-261-2790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 E 77th St Fl 10",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100751851",
            "country_code": "US",
            "telephone_number": "212-434-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "256-C Mason Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "10305",
            "country_code": "US",
            "telephone_number": "718-226-1251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUSUPOV",
        "first_name": "STEVE",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2022-07-21",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "057086",
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NY",
            "license": "285541",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEVE",
            "last_name": "YUSUPOV",
            "prefix": "DR.",
            "credential": "DDS, MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ybreast LLC
• Hampton William Young, RN
• Nina Yousefzadeh, PHARMD
• Hannah Jean Yu, M.D.
• Gregory Yunov
• Marina Yusupova
• Hoda Abdelmoneim Zaabal, PHYSICAL THERAPIST
• Gregory Zacarese, RD
• Alan R Zakheim, M.D.
• Samantha Zaleski, PA

• Oral & Maxillofacial Surgery (D.M.D.) in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.