Individual provider Active NPI

Ji Can Yang, DO

  • Cardiovascular Disease Physician
  • Bay Shore, NY
National Provider Identifier
1093004012
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
267858 Issued in NY
Practice address
301 E Main St
Bay Shore, NY 11706-8408
Phone
(631) 968-3000
NPI assigned
Mar 30, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 267858 NY
Cardiovascular Disease Physician 207RC0000X 267858 NY Primary

Addresses

Primary practice location

301 E Main St
Bay Shore, NY 11706-8408

Mailing address

506 6TH St
Brooklyn, NY 11215-3609
Phone (718) 780-7830

Other practice location 1

6 Care Ln
Saratoga Springs, NY 12866-8651
Phone (518) 587-7625

Other practice location 2

39 Brentwood Rd
Bay Shore, NY 11706-8031
Phone (631) 591-7400

Other practice location 3

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3000

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
I20180216001543 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1557621331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
New York College of Osteo Medicine of New York Institute of Technology, 2011
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)

39 Brentwood Rd
Bay Shore, NY 11706-8010
Phone (631) 666-5864

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
267858NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Cardiovascular Disease CurrentSince Apr 6, 2019 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Internal Medicine CurrentSince Apr 6, 2019 Accepting new patients

Locations

39 Brentwood Rd
Bay Shore, NY 11706
Phone (631) 591-7400

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

39 Brentwood Rd
Ste 101
Bay Shore, NY 11706
Phone (631) 590-7400

402 Potter Blvd
Brightwaters, NY 11718
Phone (631) 689-1400

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

300 Community Dr
Plandome, NY 11030

6 Care Ln
Saratoga Springs, NY 12866
Phone (518) 581-1415

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Networks

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

Interoperability endpoints

  • Direct secure messaging: jyang64456@northwell.direct-ci.com

Organizations & group practices 4

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 5

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": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1093004012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-968-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Care Ln",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128668651",
            "country_code": "US",
            "telephone_number": "518-587-7625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "39 Brentwood Rd",
            "address_purpose": "LOCATION",
            "city": "Bay Shore",
            "state": "NY",
            "postal_code": "117068031",
            "country_code": "US",
            "telephone_number": "631-591-7400",
            "fax_number": "631-591-7401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "506 6th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11215",
            "country_code": "US",
            "telephone_number": "718-780-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "JI CAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-30",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "267858",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "267858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.