Individual provider Active NPI

Kevin Yiming Yan, MD

  • Neuro-ophthalmology Physician
  • New York, NY
National Provider Identifier
1265061691
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuro-ophthalmology PhysicianTaxonomy code 207WX0109X
License
333715 Issued in NY
Practice address
17 E 102ND St FL 8
New York, NY 10029-5204
Phone
(212) 241-1159
Fax
(332) 777-0566
NPI assigned
Apr 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 333715 NY
Neuro-ophthalmology Physician 207WX0109X 333715 NY Primary

Addresses

Primary practice location

17 E 102ND St FL 8
New York, NY 10029-5204

Mailing address

1365B Clifton Rd NE Ste B4500
Atlanta, GA 30322-1013
Phone (404) 778-5360

Other practice location 1

310 E 14th St
South Building, 3rd Floor
New York, NY 10003-4284
Phone (212) 979-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240522002201 GA Practitioner - Ophthalmology 7416370903 Reassigns benefits to 2 organizations
I20250416001253 NY Practitioner - Neurology 7416370903 Reassigns benefits to 1 organization
I20250628000168 NY Practitioner - Ophthalmology 7416370903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Massachusetts Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, shared by 32 NPIs, 2,809 clinicians

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 241-4572

1 Gustave Levy Place
Mount Sinai Emergency Room
New York, NY 10029-6500
Phone (212) 241-4572

17 E 102ND St 8TH FL
Ophthalmology Department of Mount
New York, NY 10029-5204
Phone 212241811848118

5 E 98TH St 2ND FL
New York, NY 10029-6501
Phone (212) 241-4572

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • Ny Eye and Ear Infirmary of Mount Sinai Hospital, New York, NY, CCN 330100

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
333715NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince May 9, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince May 1, 2025 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince May 9, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2025 Accepting new patients
The Emory Clinic Inc CurrentSince May 9, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince May 1, 2025 Accepting new patients
Emory Health Care Neurology Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1365 Clifton Rd NE
Ste B4500
Atlanta, GA 30322

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

17 E 102nd St
Fl 8
New York, NY 10029
Phone (212) 241-0939

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

310 E 14th St
New York, NY 10003
Phone (212) 979-4000

310 E 14th St
Bldg 3RD
New York, NY 10003
Phone (212) 477-7540

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

Networks

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

Interoperability endpoints

  • Direct secure messaging: kyan896882@direct.emory.org

Organizations & group practices 7

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 7

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1265061691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365B CLIFTON RD NE STE B4500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-5360",
            "fax_number": "404-778-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E 102ND ST FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295204",
            "telephone_number": "212-241-1159",
            "fax_number": "332-777-0566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 E 14th St",
            "address_2": "South Building, 3rd Floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100034284",
            "country_code": "US",
            "telephone_number": "212-979-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAN",
        "first_name": "KEVIN",
        "middle_name": "YIMING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "333715",
            "primary": false
        },
        {
            "code": "207WX0109X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": "NY",
            "license": "333715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.