DR. ANDREY YUSUPOV (NPI# 1598059461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598059461 |
| Entity Type | Individual |
| Full Name | DR. ANDREY YUSUPOV |
| Credential | M.D. |
| Practice Address |
4076 Neely Rd Fort Wainwright AK 99703 |
| Mailing Address |
2008b Southern Ave Fairbanks AK 99709-4237 |
| Practice Telephone | 9073615024 |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2018-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD-17154 | HI | Allopathic & Osteopathic Physicians |
| Street Address |
4076 NEELY RD |
| City | FORT WAINWRIGHT |
| State | AK |
| Zip Code | 99703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720021421 | Michael Shawn Neff | Family Medicine | 4076 Neely Rd, Basset Army Community Hospital, Fort Wainwright, AK 99703 | 2006-06-13 |
| 1295215515 | Aimee Duncan | Dietitian, Registered | 4076 Neely Rd, Fort Wainwright, AK 99703 | 2018-08-16 |
| 1891243374 | Lorna D Newman-hill | Nurse Practitioner | 4076 Neely Rd, Fort Wainwright, AK 99703-1376 | 2016-09-14 |
| 1053775213 | Robert Fisher | Licensed Practical Nurse | 4076 Neely Rd, Bassett Army Community Hospital Internal Med Clinic, Fort Wainwright, AK 99703 | 2016-04-13 |
| 1023492394 | Sean Gregory Penberthy | Obstetrics & Gynecology | 4076 Neely Rd, Fort Wainwright, AK 99703 | 2015-07-16 |
| 1902210552 | Christina Remmert | Internal Medicine | 4076 Neely Rd, Bassett Army Community Hospital, Fort Wainwright, AK 99703 | 2014-06-11 |
| 1306289764 | Steven George Ward | Orthopaedic Surgery | 4076 Neely Rd, Fort Wainwright, AK 99703 | 2013-04-16 |
| 1023356797 | Momodoulamin Si Drammeh | Physician Assistant | 4076 Neely Rd, Fort Wainwright, AK 99703 | 2013-01-30 |
| 1093062861 | Joshua Glenn Hyatt | Dentist | 4076 Neely Rd, Fort Wainwright, AK 99703 | 2012-08-10 |
| 1063746931 | Darnell Autry Durrah Jr. | Psychologist | 4076 Neely Rd, Fort Wainwright, AK 99703 | 2009-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144866435 | Rebecca P Conner | Registered Nurse | Bach, 1060 Gafney Rd, Ft Wainwright, AK 99703 | 2019-11-21 |
| 1881242030 | Stephanie Morse | Counselor | Bldg 3406 Alder Ave, Ft. Wainwright, AK 99703 | 2019-08-30 |
| 1801376702 | Matthew Gerard Somma | Physician Assistant | 1-25 Attack Reconnaissance Bn, Fort Wainwright, AK 99703 | 2018-08-20 |
| 1003268657 | Brandy Tristan | Dental Hygienist | Bldg 3406, Troop Dental Clinic, Ft. Wainwright, AK 99703 | 2016-07-07 |
| 1174998918 | Jeffrey Grace | Physician Assistant | Bassett Army Medical Center (kamish Clinic), 1060 Gaffney Rd, Ft Wainwright, AK 99703 | 2015-12-04 |
| 1073999215 | Melanie Anne Whalen | Dentist | 4055 Tamarak Dr, Ft Wainwright, AK 99703 | 2015-08-10 |
| 1790183176 | Sally Jane Rall | Counselor | 3406 Adler Ave, Fairbanks, AK 99703 | 2014-12-16 |
| 1083029193 | Francesann Hill | General Practice | 3214 East Santiago Avenue, Apo, AP 99703 | 2014-06-26 |
| 1669883146 | Amber Benton | Psychiatry & Neurology | 4005-4007 602nd St, Fort Wainwright, AK 99703 | 2014-05-18 |
| 1952720898 | Allison Hubert | Occupational Therapist | 3410 Rhineland Ave, Rm 108, Fort Wainwright, AK 99703 | 2014-04-08 |
| Find all providers in zip 99703 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619437373 | Iv Radiology Medical Group | Radiology | 9178 Eagle River Ln, Eagle River, AK 99577-6819 | 2019-03-20 |
| 1316328263 | Telerad Account Management of Alaska LLC | Radiology | 3868 N Forestwood Dr, Palmer, AK 99645-9669 | 2015-06-17 |
| 1386986917 | Elaine Clark Pigman | Radiology | Alaska Radiology Associates, 3650 Piper St. Suite A, Anchorage, AK 99508 | 2013-03-21 |
| 1396011300 | Alexander Glen Wright | Radiology | 3650 Piper Street Ste A, Anchorage, AK 99508 | 2012-03-25 |
| 1063785749 | Jonathan Rasmussen | Radiology | 1060 Gaffney Rd Dept Of, Ft Wainwright, AK 99703-5002 | 2012-02-11 |
| 1669705562 | Matrix Radiology Associates, LLC | Radiology | 2440 E Tudor Rd, #238, Anchorage, AK 99507-1185 | 2009-09-09 |
| 1659500866 | William W. Resinger | Radiology | 17330 East Huntley Rd., Palmer, AK 99645-0839 | 2009-07-09 |
| 1992975122 | Pacific Northwest Radiology LLC | Radiology | 310 Bennett St, Wrangell, AK 99929 | 2008-03-04 |
| 1336348937 | Aurora Diagnostic Imaging LLC | Radiology | 3419 Airport Way Ste D, Fairbanks, AK 99709-4761 | 2007-07-13 |
| 1356560908 | Pacific Northwest Radiology | Radiology | 34 Lavalle Ct, Unalaska, AK 99685-1202 | 2007-04-24 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAINWRIGHT |
| Zip Code | 99703 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.