Individual provider Active NPI

Jian Yang, MD

  • Urology Physician
  • North New Hyde Park, NY
National Provider Identifier
1124647557
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
325636 Issued in NY
Practice address
450 Lakeville Rd Ste M42
North New Hyde Park, NY 11042-1117
Phone
(516) 734-8500
NPI assigned
Apr 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 325636 NY
Student in an Organized Health Care Education/Training Program 390200000X
Urology Physician 208800000X 325636 NY Primary

Addresses

Primary practice location

450 Lakeville Rd Ste M42
North New Hyde Park, NY 11042-1117

Mailing address

450 Lakeville Rd Ste M42
North New Hyde Park, NY 11042-1117

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
I20231019002805 NY Practitioner - Family PracticePractitioner - Urology 5698121135 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
325636NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TBHC Medical Services PC Family Medicine CurrentSince Sep 6, 2023 Accepting new patients
North Shore-Lij Medical PC Family Medicine Past Accepting new patients

Locations

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

Organizations & group practices 2

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": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1124647557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 LAKEVILLE RD STE M42",
            "city": "NORTH NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 LAKEVILLE RD STE M42",
            "city": "NORTH NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421117",
            "telephone_number": "516-734-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "JIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "325636",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "325636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.