Individual provider Active NPI

Yudhistira Persaud, MD

  • Allergy Physician
  • Bronx, NY
National Provider Identifier
1124201322
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
231667 Issued in NY
Practice address
1276 Fulton Ave
Bronx, NY 10456-3402
Phone
(718) 590-1800
Fax
(718) 518-5124
NPI assigned
Dec 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 231667 NY Primary

Addresses

Primary practice location

1276 Fulton Ave
Bronx, NY 10456-3402

Mailing address

14833 87TH Rd
Briarwood, NY 11435-3113
Phone (917) 584-6770

Other identifiers 1

IdentifierTypeStateIssuer
231667OtherNYSTATE LICENSE

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
I20080908000171 NY Practitioner - Allergy/Immunology 5193891695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
State University of New York Downstate Medical Center, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1650 Grand Concourse
Suite 1
Bronx, NY 10457-7606
Phone (718) 960-2040

8814 198TH St
Hollis, NY 11423-2119
Phone (718) 470-2345

Hospital & facility affiliations

  • Bronxcare Hospital Center Hospital, Bronx, NY, CCN 330009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
231667NYMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Sep 12, 2006 Accepting new patients
Bronxcare Health System CurrentSince Sep 12, 2006 Accepting new patients
New York Allergy & Asthma Care PC CurrentSince Jan 21, 2026 Accepting new patients
Bronxcare Health System Past Accepting new patients
Bronxcare Health System Past Accepting new patients
Bronxcare Dr. Martin Luther King Jr. Health Center Past Accepting new patients

Locations

1650 Grand Concourse
#1
Bronx, NY 10457
Phone (718) 960-2040

1276 Fulton Ave
#208
Bronx, NY 10456
Phone (718) 901-8911

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Networks

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

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 1

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": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1124201322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14833 87TH RD",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114353113",
            "telephone_number": "917-584-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-590-1800",
            "fax_number": "718-518-5124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSAUD",
        "first_name": "YUDHISTIRA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "NY",
            "license": "231667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "231667",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.