BUSHWICK PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC
NPI 1003393299
Surgery - Vascular Surgery in Brooklyn, NY

Q: What is Bushwick Professional Medical Services Of New York LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Active since July 20, 2018CLIA 33D2161180 · Waiver

441 KNICKERBOCKER AVE STE A, BROOKLYN, NY 11237(347) 773-2684(718) 261-3893 Get Directions Write a Review

NPPES record last updated: July 20, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Bushwick Professional Medical Services Of New York Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BUSHWICK PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC (NPI 1003393299) is a healthcare organization registered as a vascular surgery in Brooklyn, New York and active in the NPI registry since July 2018. The organization holds a CLIA Waiver certificate valid through January 28, 2027 and lists Yan Katsnelson, Owner, as its authorized official.

NPPES Registry Identity

NPI1003393299

Entity TypeOrganization

Primary Taxonomy2086S0129X

Legal Business NameBUSHWICK PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC

Location Address441 KNICKERBOCKER AVE STE ABrooklyn, NY 11237-4508

Mailing AddressPo Box 32Northbrook, IL 60065-0032 · (847) 593-8460 · Fax (224) 235-4652

Phone(347) 773-2684

Fax(718) 261-3893

Organization SubpartNo

Authorized OfficialYan KatsnelsonOwner · (224) 318-0118

Enumeration DateJuly 20, 2018

✔ NPI 1003393299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0129X

Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

441 KNICKERBOCKER AVE STE A, Brooklyn, NY 11237

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2161180

Bushwick Professional Medical Services Of New York LLC · Brooklyn, NY

Active · expires Jan 28, 2027

CLIA Number33D2161180

Laboratory TypePhysician Office

Certificate Effective DateJanuary 29, 2025

Certificate Expiration DateJanuary 28, 2027

Laboratory DirectorMs. Patricia Clarke

Laboratory Phone(347) 537-2755

Laboratory LocationBushwick Professional Medical Services Of New York LLC441 Knickerbocker Avenue, Brooklyn, NY 11237

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bushwick Professional Medical Services Of New York LLC's NPI number?

The NPI number for Bushwick Professional Medical Services Of New York LLC is 1003393299. It was assigned to this organization in the NPPES registry on July 20, 2018.

Where is Bushwick Professional Medical Services Of New York LLC located?

Bushwick Professional Medical Services Of New York LLC is located at 441 Knickerbocker Ave Ste A, Brooklyn, NY 11237. The listed phone number is (347) 773-2684.

What is Bushwick Professional Medical Services Of New York LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Does Bushwick Professional Medical Services Of New York LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2161180) is associated with this NPI, valid through January 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bushwick Professional Medical Services Of New York LLC was last updated on July 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.