Yelena Rybakov, Physician Assistant
Physician Assistant, Medical in Bronx, NY. Individual provider (NPI-1).
NPI number1609915313
StatusActive
Last updated in NPPESNov 22, 2019
Details
- NPI
- 1609915313
- Entity type
- Individual (NPI-1)
- Name
- Miss Yelena Rybakov
- Credential
- Physician Assistant
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 6, 2007
- Last updated
- Nov 22, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | – | Yes |
Practice location
1825 Eastchester RdBronx, NY 10461-2301
Phone 718-904-3101 · Fax 718-904-2827
Mailing address
8344 Lefferts Blvd Apt 2bKew Gardens, NY 11415-2547
Phone 646-775-5612 · Fax 718-904-2827
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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