Edwardo M Yambo MD PC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

EDWARDO M YAMBO MD PC

Practice address

41 Brentwood Rd
Bay Shore, NY 11706

Phone

(631) 968-0800

Fax

(631) 665-0816

NPI assigned

Sep 12, 2006

Last updated

Aug 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edwardo Marth Yambo, MD

Title

Owner

Phone

(631) 968-0800

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Practitioners 4

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.

• Ryan Edward Baker, RPAC

  • Medical Physician Assistant
  • Deer Park, NY
  • NPI 1992077069
  NPD (past)
• Jeetinder K Gujral

  • Hospitalist Physician
  • Bay Shore, NY
  • NPI 1437295086
  NPD (past)
• Andrew M Hararah, D.O.

  • Family Medicine Physician
  • Amityville, NY
  • NPI 1104920255
  NPD (past)
• Dennis Ponteres, P.T.

  • Physical Therapist
  • North Babylon, NY
  • NPI 1164480414
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1194829754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BRENTWOOD RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066923",
            "telephone_number": "631-968-0800",
            "fax_number": "316-650-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BRENTWOOD RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-968-0800",
            "fax_number": "631-665-0816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 EAST INDUSTRY COURT",
            "address_purpose": "LOCATION",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117294728",
            "country_code": "US",
            "telephone_number": "631-667-0222",
            "fax_number": "631-667-0223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EDWARDO M YAMBO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "YAMBO",
        "authorized_official_first_name": "EDWARDO",
        "authorized_official_middle_name": "MARTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-968-0800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962591271",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1164480414",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candice Edelstein, M.S. CCC-SLP
• Christine Elizabeth Edelstein, MSED
• Edison R. Blanco Physician PC
• Norma Edmond
• Edward J Hallal Jr MD PC
• Alyssa Louise Edwards
• Sharlene Edwards
• Camron M Einerman, DPT
• Charles B Eisenson, DDS
• Zakia Eleazer

• Adult Medicine Physician in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Adult Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.