NPIMap

Individual provider Active NPI

Robert Yohannan, MD

  • Nephrology Physician
  • Huntington, NY
National Provider Identifier
1255300216
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
229388 Issued in NY
Practice address
325 Park Ave
Huntington, NY 11743-2779
Phone
(631) 351-3784
NPI assigned
Mar 14, 2006
Last updated
May 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 229388 NY Primary

Addresses

Primary practice location

325 Park Ave
Huntington, NY 11743-2779

Mailing address

5 Cuba Hill Rd
Greenlawn, NY 11740-1624
Phone (631) 351-3784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019000870 NY Practitioner - NephrologyPractitioner - Internal Medicine 0244205789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5 Cuba Hill Rd
Greenlawn, NY 11740-1624
Phone (631) 628-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221402MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Apr 1, 2020 Accepting new patients
North Shore - Lij Medical PC CurrentSince Apr 1, 2020 Accepting new patients
Holyoke Medical Center, Inc. PastSince Oct 24, 1995 Accepting new patients

Locations

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

300 Community Dr
Manhasset, NY 11030

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1255300216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CUBA HILL RD",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401624",
            "telephone_number": "631-351-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432779",
            "telephone_number": "631-351-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOHANNAN",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "229388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.