Active NPI
Michael Jay Yellin, MD
- Rheumatology Physician
- Montclair, NJ
National Provider Identifier
1164741641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 25MA08368400
- Practice address
- 138 Buckingham Rd
Montclair, NJ 07043-2307 - Phone
- (973) 744-7093
- Fax
- (203) 764-2416
- NPI assigned
- May 24, 2010
- Last updated
- May 24, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 25MA08368400 | NJ | Primary |
Addresses
Primary practice location
138 Buckingham Rd
Montclair, NJ 07043-2307
Mailing address
138 Buckingham Rd
Montclair, NJ 07043-2307
Phone (973) 744-7093
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA08368400 | NJ | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274659200000",
"number": "1164741641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 BUCKINGHAM RD",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070432307",
"telephone_number": "973-744-7093",
"fax_number": "203-764-2416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 BUCKINGHAM RD",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070432307",
"telephone_number": "973-744-7093",
"fax_number": "203-764-2416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YELLIN",
"first_name": "MICHAEL",
"middle_name": "JAY",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-24",
"last_updated": "2010-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "NJ",
"license": "25MA08368400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.