Individual provider Active NPI

Shana Nayoung Yun, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1053297663
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
011208 Issued in NY
Practice address
20 Rockwell PL Apt 1513
Brooklyn, NY 11201-8064
Phone
(714) 299-7485
NPI assigned
Aug 12, 2025
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 011208 NY Primary

Addresses

Primary practice location

20 Rockwell PL Apt 1513
Brooklyn, NY 11201-8064

Mailing address

20 Rockwell PL Apt 1513
Brooklyn, NY 11201-8064
Phone (714) 299-7485

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260608000039 NY Practitioner - Optometry 0547731952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1511 Fulton St
Brooklyn, NY 11216-5351

1511 Fulton St
Brooklyn, NY 11216-5359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011208NYMDSpeech-Language Pathologist

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1053297663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ROCKWELL PL APT 1513",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112018064",
            "telephone_number": "714-299-7485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ROCKWELL PL APT 1513",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112018064",
            "telephone_number": "714-299-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUN",
        "first_name": "SHANA",
        "middle_name": "NAYOUNG",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.