Individual provider Active NPI

Jason Yan, M.D.

  • Emergency Medicine Physician
  • Valley Stream, NY
National Provider Identifier
1053678250
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
284940 Issued in NY
Practice address
900 Franklin Ave
Valley Stream, NY 11580-2145
Phone
(516) 256-6306
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 284940 NY Primary

Addresses

Primary practice location

900 Franklin Ave
Valley Stream, NY 11580-2145

Mailing address

900 Franklin Ave
Valley Stream, NY 11580-2145
Phone (516) 256-6306

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161026002581 NY Practitioner - Emergency Medicine 9739467770 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Arizona College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

95 -25 Queens Boulevard
Rego Park, NY 11374-4510
Phone (718) 925-6565

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
John T. Mather Memorial Hospital Current Accepting new patients
John T Mather Memorial Hospital Current Accepting new patients
John T. Mather Memorial Hospital Emergency Medicine CurrentSince Oct 25, 2022 Accepting new patients
John T. Mather Memorial Hospital CurrentSince Oct 25, 2022 Accepting new patients
John T Mather Memorial Hospital Current Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Jul 8, 2016 Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

100 Highlands Blvd
#9
Port Jefferson, NY 11777
Phone (631) 686-7809

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

9525 Queens Blvd
Rego Park, NY 11374
Phone (718) 286-1000

900 Franklin Ave
Valley Stream, NY 11580
Phone (516) 256-6000

Networks

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

Interoperability endpoints

  • Direct secure messaging: jyan65355@northwell.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1053678250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 FRANKLIN AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802145",
            "telephone_number": "516-256-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 FRANKLIN AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802145",
            "telephone_number": "516-256-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "JASON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "284940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.