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MR. EMANUEL YUSUPOV PA
NPI 1629362439
Physician Assistant - Surgical in Elmhurst, NY

Active since June 09, 2011PECOS Enrolled
79-01 BROADWAY, ELMHURST, NY 11373(718) 334-1921(718) 334-5958 Get Directions Write a Review

NPPES record last updated: June 9, 2011. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mr. Emanuel Yusupov Pa NPPES

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

MR. EMANUEL YUSUPOV PA (NPI 1629362439) is an individual surgical provider in Elmhurst, New York, licensed in New York (014745) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629362439
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. EMANUEL YUSUPOVCredential: PA
Location Address79-01 BROADWAYElmhurst, NY 11373
Mailing Address79-01 BroadwayElmhurst, NY 11373 · (718) 334-1921 · Fax (718) 334-5958
Phone(718) 334-1921
Fax(718) 334-5958
Sole ProprietorNo
Enumeration DateJune 9, 2011
✔ NPI 1629362439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in NY · 014745
79-01 BROADWAY, Elmhurst, NY 11373
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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)

Mr. Emanuel Yusupov 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 20

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

CHANA HOCHMAN AUD
Audiologist
79-01 BROADWAY
ELMHURST, NY 11373
Queens County (718) 334-1921
EKAETE ANIETIE EKPENYONG PHYSICIAN ASSISTANT
Physician Assistant
79-01 BROADWAY, ELMHURST HOSPITAL CENTER
ELMHURST, NY 11373
Queens County (718) 334-3556
AZFAR SHABBIR M.D.
Pediatrics (Neonatal-Perinatal Medicine)
79-01 BROADWAY, ROOM A1-9
ELMHURST, NY 11373
Queens County (718) 334-4952
MS. SHEUNG-CHI NG NP
Nurse Practitioner (Psychiatric/Mental Health)
79-01 BROADWAY, MANAGED CARE, D1-01
ELMHURST, NY 11373
Queens County (718) 334-1921
JOSE ALEJANDRO MOREIRA MUSA M.D.
Student in an Organized Health Care Education/Training Program
79-01 BROADWAY
QUEENS, NY 11373
Queens County (718) 334-2156
MS. CHIH-YUN LUO NP
Nurse Practitioner (Primary Care)
79-01 BROADWAY, D4 -54 CARDIOLOGY DEPT
ELMHURST, NY 11373
Queens County (718) 334-2508
MR. BARNEY CHOW LMSW
Social Worker
79-01 BROADWAY
ELMHURST, NY 11373
Queens County (718) 334-4000
NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
General Acute Care Hospital
79-01 BROADWAY
ELMHURST, NY 11373
Queens County (718) 334-4900

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 Emanuel Yusupov's NPI number?

The NPI number for Emanuel Yusupov is 1629362439. It was assigned to this individual provider in the NPPES registry on June 9, 2011.

Where is Emanuel Yusupov located?

Emanuel Yusupov practices at 79-01 Broadway, Elmhurst, NY 11373. The listed phone number is (718) 334-1921.

What is Emanuel Yusupov's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Emanuel Yusupov enrolled in Medicare?

Yes. Emanuel Yusupov is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Emanuel Yusupov was last updated on June 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.