Active NPI
Yu Jen Lai, MD
- Physical Medicine & Rehabilitation Physician
- Port Jefferson, NY
National Provider Identifier
1083787071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 211328
- Practice address
- 200 Belle Terre Rd
Suite E740
Port Jefferson, NY 11777 - Phone
- (631) 474-6879
- Fax
- (631) 474-6448
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 211328 | NY | Primary |
Addresses
Primary practice location
200 Belle Terre Rd
Suite E740
Port Jefferson, NY 11777
Mailing address
200 Belle Terre Rd
Suite E740
Port Jefferson, NY 11777
Phone (631) 474-6879
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01898493 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CHS Physician Partners, PC | Current | Accepting new patients |
Interoperability endpoints
- ylai55956@direct-chsli.net
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 and National Provider Directory roles.
-
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- Fresh Meadows, NY
- NPI 1407089345
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278374400000",
"number": "1083787071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 BELLE TERRE RD",
"address_2": "SUITE E740",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "11777",
"telephone_number": "631-474-6879",
"fax_number": "631-474-6448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 BELLE TERRE RD",
"address_2": "SUITE E740",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "11777",
"telephone_number": "631-474-6879",
"fax_number": "631-474-6448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAI",
"first_name": "YU JEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2010-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "NY",
"license": "211328",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01898493",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.