Individual provider Active NPI

Eduardo V Yarur, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1033447404
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013652 Issued in NY
Practice address
309 W 23Rd St
2ND Floor
New York, NY 10011-2202
Phone
(212) 352-2600
Fax
(212) 620-7599
NPI assigned
Nov 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013652 NY Primary

Addresses

Primary practice location

309 W 23Rd St
2ND Floor
New York, NY 10011-2202

Mailing address

309 W 23Rd St
2ND Floor
New York, NY 10011-2202
Phone (212) 352-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091214000002 NY Practitioner - Physician Assistant 3779623327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

309 W 23Rd St
New York, NY 10011-2202
Phone (212) 352-2600

55 E 34TH St
New York, NY 10016-4337
Phone (212) 252-6131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013652NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 20, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

309 W 23rd St
#2
New York, NY 10011
Phone (212) 256-7000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1033447404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W 23RD ST",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112202",
            "telephone_number": "212-352-2600",
            "fax_number": "212-620-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W 23RD ST",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112202",
            "telephone_number": "212-352-2600",
            "fax_number": "212-620-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARUR",
        "first_name": "EDUARDO",
        "middle_name": "V",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-24",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.