Individual provider Active NPI

Jeffrey Yellin, DPT

  • Physical Therapist
  • East Meadow, NY
National Provider Identifier
1205979945
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028766 Issued in NY
Practice address
1889 Lincoln Ave
East Meadow, NY 11554-2522
Phone
(516) 659-4904
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 028766 NY Primary

Addresses

Primary practice location

1889 Lincoln Ave
East Meadow, NY 11554-2522

Mailing address

1889 Lincoln Ave
East Meadow, NY 11554-2522
Phone (516) 659-4904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070315000174 NY Practitioner - Physical Therapist in Private Practice 0244333003 Reassigns benefits to 2 organizations
Practice locations: East Meadow, NY

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Edge Physical Therapy PCGroup PAC ID 2860805025, 2 clinicians

Practice addresses (Care Compare)

East Meadow, NY 11554
Phone (516) 659-4904

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028766NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
American Edge Physical Therapy, P.C. Physical Therapist CurrentSince Nov 2, 2020 Accepting new patients
Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC Physical Therapist CurrentSince Dec 8, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1205979945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1889 LINCOLN AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542522",
            "telephone_number": "516-659-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1889 LINCOLN AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542522",
            "telephone_number": "516-659-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLIN",
        "first_name": "JEFFREY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.