Organization Active NPI

Yan Medical PC

  • Pulmonary Disease Physician
  • Brooklyn, NY
National Provider Identifier
1023481264
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
196486 Issued in NY
Legal business name
YAN MEDICAL PC
Practice address
2511 Ocean Ave
Suite 104
Brooklyn, NY 11229-3950
Phone
(718) 907-0198
Fax
(718) 942-5323
NPI assigned
Nov 10, 2015
Last updated
Nov 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard Yan
Title
President
Phone
(718) 907-0198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X 196486 NY Primary

Addresses

Primary practice location

2511 Ocean Ave
Suite 104
Brooklyn, NY 11229-3950

Mailing address

2511 Ocean Ave
Suite 104
Brooklyn, NY 11229-3950
Phone (718) 907-0198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160127002004 NY Part B Supplier - Clinic/Group Practice 2567765472 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

2411 Ocean Ave
Ste 104
Brooklyn, NY 11229

2511 Ocean Ave
Ste 104
Brooklyn, NY 11229
Phone (718) 615-0400

743 58th St
Lowr
Brooklyn, NY 11220
Phone (718) 732-8800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1023481264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 OCEAN AVE",
            "address_2": "SUITE 104",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293950",
            "telephone_number": "718-907-0198",
            "fax_number": "718-942-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 OCEAN AVE",
            "address_2": "SUITE 104",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293950",
            "telephone_number": "718-907-0198",
            "fax_number": "718-942-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAN MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "YAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-907-0198"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "196486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.