Active NPI
Kayla Marie Yanga, FNP-C
- Family Medicine Physician
- Nutley, NJ
National Provider Identifier
1124887732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 26NJ15034500
- Practice address
- 88 Park Ave Ste 1a
Nutley, NJ 07110-3500 - Phone
- (908) 450-7002
- NPI assigned
- Mar 18, 2024
- Last updated
- Mar 18, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26NJ15034500 | NJ | Primary |
Addresses
Primary practice location
88 Park Ave Ste 1a
Nutley, NJ 07110-3500
Mailing address
88 Park Ave Ste 1a
Nutley, NJ 07110-3500
Phone (908) 450-7002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ15034500 | NJ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premiermd | Family Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1124887732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 PARK AVE STE 1A",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "071103500",
"telephone_number": "908-450-7002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 PARK AVE STE 1A",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "071103500",
"telephone_number": "908-450-7002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANGA",
"first_name": "KAYLA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-18",
"last_updated": "2024-03-18",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NJ",
"license": "26NJ15034500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nutley, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.