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AVITAL YAGUDAEV PA
NPI 1164594156
Physician Assistant - Medical in Howard Beach, NY

Active since November 14, 2006PECOS Enrolled
15705 CROSSBAY BLVD, HOWARD BEACH, NY 11414(718) 845-5252(718) 845-6464 Get Directions Write a Review

NPPES record last updated: June 6, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Avital Yagudaev Pa NPPES

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

AVITAL YAGUDAEV PA (NPI 1164594156) is an individual medical provider in Howard Beach, New York, licensed in New York (009742) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164594156
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameAVITAL YAGUDAEVCredential: PA
Location Address15705 CROSSBAY BLVDHoward Beach, NY 11414-2748
Mailing Address210 Howard StEast Williston, NY 11596-1420 · (917) 658-0100
Phone(718) 845-5252
Fax(718) 845-6464
Sole ProprietorNo
Enumeration DateNovember 14, 2006
Last NPPES UpdateJune 6, 2025
NPPES CertifiedJune 6, 2025
✔ NPI 1164594156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NY · 009742
15705 CROSSBAY BLVD, Howard Beach, NY 11414
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Avital Yagudaev Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNA SCARPITTA R.PH
Pharmacist
15705 CROSSBAY BLVD
HOWARD BEACH, NY 11414
Queens County (718) 848-4507
DR. MICHELLE KOMLO PHARMD.
Pharmacist
15705 CROSSBAY BLVD
HOWARD BEACH, NY 11414
Queens County (718) 848-4507
DR. GASPARE GIOVANNI SCARANTINO D.C.
Chiropractor
15705 CROSSBAY BLVD
HOWARD BEACH, NY 11414
Queens County (718) 845-5252
STEPHANIE M MARTIN
Pharmacist
15705 CROSSBAY BLVD
HOWARD BEACH, NY 11414
Queens County (718) 848-4507
NANCY CATHOLIC
Physical Therapist
15705 CROSSBAY BLVD
HOWARD BEACH, NY 11414
Queens County (718) 520-8480
STEPHANIE MARIE ANGELINO PHARM.D.
Pharmacist
15705 CROSSBAY BLVD
HOWARD BEACH, NY 11414
Queens County (718) 848-4507
MR. MICHAEL A FRAZZETTA R.PH
Pharmacist
15705 CROSSBAY BLVD
HOWARD BEACH, NY 11414
Queens County (646) 872-5100
JILLIAN URQUHART
Pharmacist
15705 CROSSBAY BLVD
HOWARD BEACH, NY 11414
Queens County (718) 848-4507

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 Avital Yagudaev's NPI number?

The NPI number for Avital Yagudaev is 1164594156. It was assigned to this individual provider in the NPPES registry on November 14, 2006.

Where is Avital Yagudaev located?

Avital Yagudaev practices at 15705 Crossbay Blvd, Howard Beach, NY 11414. The listed phone number is (718) 845-5252.

What is Avital Yagudaev's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Avital Yagudaev enrolled in Medicare?

Yes. Avital Yagudaev is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Avital Yagudaev was last updated on June 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.