Individual provider Active NPI

Ka Dey Yang, PA

  • Physician Assistant
  • Mamaroneck, NY
National Provider Identifier
1144864711
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028626-01 Issued in NY
Practice address
444 E Boston Post Rd Ste 201
Mamaroneck, NY 10543-3704
Phone
(914) 834-1777
NPI assigned
Nov 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13251 MN
Physician Assistant 363A00000X 028626-01 NY Primary

Addresses

Primary practice location

444 E Boston Post Rd Ste 201
Mamaroneck, NY 10543-3704

Mailing address

1150 Desoto St
Saint Paul, MN 55130-3605
Phone (920) 544-1280

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023000648 NY Practitioner - Physician Assistant 2264853480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Allied Healthcare Physician PLLCGroup PAC ID 8224079744, 16 clinicians

Practice addresses (Care Compare)

150 Lockwood Ave
Suite 16
New Rochelle, NY 10801-4912
Phone (914) 235-2352

340 City Island Ave
Bronx, NY 10464-1326
Phone (718) 885-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13251MNMDPhysician Assistant
028626-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Phyllis Mandel MD PLLC Past Accepting new patients

Networks

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

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": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1144864711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 DESOTO ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551303605",
            "telephone_number": "920-544-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 E BOSTON POST RD STE 201",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105433704",
            "telephone_number": "914-834-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "KA DEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13251",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028626-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mamaroneck, NY

Sources for this page

Verify at the official NPI Registry.