Individual provider Active NPI

Christopher John Yanusas, PH.D.

  • Clinical Neuropsychologist
  • Binghamton, NY
National Provider Identifier
1205910775
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
016803 Issued in NY
Practice address
65 Pennsylvania Ave
Binghamton, NY 13903-1651
Phone
(607) 763-6033
Fax
(607) 763-6853
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 016803 NY Primary

Addresses

Primary practice location

65 Pennsylvania Ave
Binghamton, NY 13903-1651

Mailing address

346 Grand Ave
Johnson City, NY 13790-2580
Phone (607) 763-6033

Other identifiers 1

IdentifierTypeStateIssuer
03165762MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090409000106 PA Practitioner - Clinical Psychologist 1850448887 Practice locations: Dunmore, PA
I20100702000214 NY Practitioner - Clinical Psychologist 1850448887 Reassigns benefits to 1 organization
Practice locations: Binghamton, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1141 Clay Ave
Suite 4
Dunmore, PA 18510-1191
Phone (570) 969-1660

Hospital & facility affiliations

  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016803NYMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates PC Past Accepting new patients

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431043200000",
    "number": "1205910775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902580",
            "telephone_number": "607-763-6033",
            "fax_number": "607-763-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PENNSYLVANIA AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139031651",
            "telephone_number": "607-763-6033",
            "fax_number": "607-763-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANUSAS",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2015-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "016803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03165762",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.