NPIMap

Individual provider Active NPI

Stephanie Leigh Yellin, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Woodbury Heights, NJ
National Provider Identifier
1104112168
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
OS016358 Issued in PA
Practice address
1006 Mantua Pike
Woodbury Heights, NJ 08097-1221
Phone
(856) 845-8600
Fax
(856) 845-4890
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS016358 PA
Sports Medicine (Family Medicine) Physician 207QS0010X OS016358 PA Primary

Addresses

Primary practice location

1006 Mantua Pike
Woodbury Heights, NJ 08097-1221

Mailing address

1006 Mantua Pike
Woodbury Heights, NJ 08097-1221
Phone (856) 845-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160621002158 PA Practitioner - Family PracticePractitioner - Sports Medicine 6507174505 Reassigns benefits to 1 organization
I20160831000396 NJ Practitioner - Sports MedicinePractitioner - Family Practice 6507174505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1006 Mantua Pike
Woodbury, NJ 08097-1221
Phone (856) 845-8600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. Family Medicine CurrentSince Jul 9, 2016 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Family Medicine CurrentSince Jul 9, 2016 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Family Medicine CurrentSince Jun 24, 2016 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jun 24, 2016 Accepting new patients

Locations

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

1006 Mantua Pike
Spc Care
Woodbury, NJ 08097
Phone (856) 845-8600

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

1001 Chesterbrook Blvd
Fl 3
Berwyn, PA 19312
Phone (610) 576-7500

1001 Chesterbrook Blvd
Berwyn, PA 19312
Phone (610) 576-7500

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

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 11

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": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1104112168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 MANTUA PIKE",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971221",
            "telephone_number": "856-845-8600",
            "fax_number": "856-845-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 MANTUA PIKE",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971221",
            "telephone_number": "856-845-8600",
            "fax_number": "856-845-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLIN",
        "first_name": "STEPHANIE",
        "middle_name": "LEIGH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS016358",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "OS016358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury Heights, NJ

Sources for this page

Verify at the official NPI Registry.