Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Georgiy Yusupov

Individual provider Family Nurse Practitioner · NPI 1164007548

Mr. Georgiy Yusupov is a Nurse Practitioner in Brooklyn, New York. Qualified in 2021, 5 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2021
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Practice location Address checks out

3709 Flatlands Ave
Brooklyn, NY 11234-3507
Phone: (718) 444-7766
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 14020 68th Dr, Flushing, NY 11367-1652 — (646) 331-5198

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F347371-01 (NY)

Record details

NPI number1164007548
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 16, 2021
Last updated in NPPESMarch 25, 2021
Certification dateMarch 25, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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