Individual provider Active NPI

Lydia Jill Yeager, NP

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1164828406
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
382502 Issued in NY
Practice address
65 Broadway FL 14
New York, NY 10006-2516
Phone
(212) 348-4000
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 382502 NY Primary

Addresses

Primary practice location

65 Broadway FL 14
New York, NY 10006-2516

Mailing address

65 Broadway FL 14
New York, NY 10006-2516
Phone (212) 348-4000

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
I20160104000719 NY Practitioner - Nurse Practitioner 3870895154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

279 E 3Rd St
New York, NY 10009-7813
Phone (212) 531-7533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
382502NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc CurrentSince Oct 4, 2015 Accepting new patients
Ryan-Chelsea Clinton Community Health Center CurrentSince Oct 4, 2015 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Oct 4, 2015 Accepting new patients

Locations

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

645 10th Ave
New York, NY 10036
Phone (212) 265-4500

110 W 97th St
#0
New York, NY 10025

Organizations & group practices 3

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": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1164828406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 BROADWAY FL 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062516",
            "telephone_number": "212-348-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BROADWAY FL 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062516",
            "telephone_number": "212-348-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAGER",
        "first_name": "LYDIA",
        "middle_name": "JILL",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "382502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.