Individual provider Active NPI

Karen Joan Yan, MD

  • Pediatrics Physician
  • Lake Success, NY
National Provider Identifier
1174576524
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
220324 Issued in NY
Practice address
2 Pro Health PLZ
Lake Success, NY 11042-1111
Phone
(516) 622-7337
Fax
(516) 622-7331
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 220324 NY Primary

Addresses

Primary practice location

2 Pro Health PLZ
Lake Success, NY 11042-1111

Mailing address

2800 Marcus Ave
Lake Success, NY 11042-1008
Phone (516) 622-7337

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181201000291 NY Practitioner - Pediatric Medicine 3375887359 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
220324NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Aug 12, 2023 Accepting new patients
Optum Medical Care, P.C. CurrentSince Aug 12, 2023 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

Philadelphia, PA 19195

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174576524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MARCUS AVE",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "110421008",
            "telephone_number": "516-622-7337",
            "fax_number": "516-622-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PRO HEALTH PLZ",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "110421111",
            "telephone_number": "516-622-7337",
            "fax_number": "516-622-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "KAREN",
        "middle_name": "JOAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "220324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Success, NY

Sources for this page

Verify at the official NPI Registry.