Individual provider Active NPI

Yelena Polyakova, D.C.

  • Chiropractor
  • Mount Kisco, NY
National Provider Identifier
1992738678
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X009791 Issued in NY
Practice address
344 E Main St
Suite 204
Mount Kisco, NY 10549-3027
Phone
(914) 242-3411
Fax
(914) 242-0985
NPI assigned
Jul 8, 2006
Last updated
Jun 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X009791 NY Primary

Addresses

Primary practice location

344 E Main St
Suite 204
Mount Kisco, NY 10549-3027

Mailing address

243 Canterbury Rd
White Plains, NY 10607-1028
Phone (917) 609-6434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408001552 NY Practitioner - Chiropractic 3678567062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

243 Canterbury Rd
White Plains, NY 10607-1028
Phone (917) 609-6434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X009791NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Practical Chiropractic, P.C. Chiropractor CurrentSince Jul 18, 2012 Accepting new patients
Bewell Chiropractic, PC Chiropractor PastSince Jul 18, 2012 Accepting new patients

Locations

344 E Main St
Ste 204
Mount Kisco, NY 10549
Phone (914) 242-3411

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1992738678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CANTERBURY RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106071028",
            "telephone_number": "917-609-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E MAIN ST",
            "address_2": "SUITE 204",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493027",
            "telephone_number": "914-242-3411",
            "fax_number": "914-242-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLYAKOVA",
        "first_name": "YELENA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X009791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; 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.