NPIMap

Organization Active NPI

Young Adult Institute, Inc.

  • Developmental Disabilities Clinic/Center
  • New York, NY
National Provider Identifier
1144314576
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
License
6113310 Issued in NY
Legal business name
YOUNG ADULT INSTITUTE, INC.
Practice address
460 West 34TH Street
9TH Floor
New York, NY 10001-2382
Phone
(212) 273-6519
Fax
(212) 273-6427
NPI assigned
Oct 2, 2006
Last updated
Apr 27, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
YOUNG ADULT INSTITUTE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Authorized official

Name
Mr. Vlad Kuznetsov, PHD, MBA, PA
Title
Executive Director
Phone
(212) 273-6116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X 6113310 NY Primary

Addresses

Primary practice location

460 West 34TH Street
9TH Floor
New York, NY 10001-2382

Mailing address

460 W 34TH St
FL 11
New York, NY 10001-2382
Phone (212) 273-6100

Other identifiers 2

IdentifierTypeStateIssuer
01457354MedicaidNY
ANCA76121OtherNYOXFORD

Other names 1

  • Young Adult Institute & Workshop, Inc. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051101000864 NY Part B Supplier - Clinic/Group Practice 1153216353 Receives reassigned benefits from 65 practitioners
Practice locations: Bayside, NY; Bronx, NY; Brooklyn, NY; New York, NY

National Provider Directory

National Provider Directory
Tax ID family
Dominic J Carbone55 organizations share this tax ID, including this one
Part of
Dominic J Carbone

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Locations

555 Washington Ave
Ste 1
Brentwood, NY 11717
Phone (631) 858-9856

227 E 41St St
New York, NY 10017

Practitioners & affiliated clinicians

Practitioners 131

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 131

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1144314576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 W 34TH ST",
            "address_2": "FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012382",
            "telephone_number": "212-273-6100",
            "fax_number": "212-273-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 WEST 34TH STREET",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012382",
            "telephone_number": "212-273-6519",
            "fax_number": "212-273-6427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG ADULT INSTITUTE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YOUNG ADULT INSTITUTE, INC.",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "KUZNETSOV",
        "authorized_official_first_name": "VLAD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "212-273-6116",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD, MBA, PA"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NY",
            "license": "6113310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01457354",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "ANCA76121",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Young Adult Institute & Workshop, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.