Individual provider Active NPI

Yaroslav Yanishin

  • Physician Assistant
  • Garden City, NY
National Provider Identifier
1083127799
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023817 Issued in NY
Practice address
229 7TH St Ste 105
Garden City, NY 11530-5766
Phone
(516) 747-7778
Fax
(516) 517-9533
NPI assigned
Nov 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 023817 NY Primary

Addresses

Primary practice location

229 7TH St Ste 105
Garden City, NY 11530-5766

Mailing address

5812 79TH St
Middle Village, NY 11379-5312
Phone (718) 541-1262

Other practice location 1

5812 79th St
Middle Village, NY 11379-5312
Phone (718) 541-1262

Other practice location 2

150 55th St
Brooklyn, NY 11220-2508
Phone (718) 541-1262

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
I20200204001685 NY Practitioner - Physician Assistant 6709212053 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schweiger Dermatology PLLCGroup PAC ID 5991947160, 254 clinicians

Practice addresses (Care Compare)

21418 24TH Ave
Bayside, NY 11360-2219
Phone (212) 283-3000

65 Broadway
Suite 1800
New York, NY 10006-2549
Phone (212) 283-3000

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023817NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 1, 2020 Accepting new patients
New York University CurrentSince Jan 1, 2020 Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: yaroslav.yanishin@schweigerderm.emadirect.md

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": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1083127799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5812 79TH ST",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113795312",
            "telephone_number": "718-541-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 7TH ST STE 105",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305766",
            "telephone_number": "516-747-7778",
            "fax_number": "516-517-9533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5812 79th St",
            "address_purpose": "LOCATION",
            "city": "Middle Village",
            "state": "NY",
            "postal_code": "113795312",
            "country_code": "US",
            "telephone_number": "718-541-1262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 55th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "718-541-1262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANISHIN",
        "first_name": "YAROSLAV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-16",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.