Active NPI
Amir Yazdani, M. D.
- Internal Medicine Physician
- Staten Island, NY
National Provider Identifier
1295723922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 158890
- Practice address
- 470 Seaview Avenue
Staten Island, NY 10305-3034 - Phone
- (718) 987-5940
- Fax
- (718) 667-9708
- NPI assigned
- Oct 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 158890 | NY | Primary |
Addresses
Primary practice location
470 Seaview Avenue
Staten Island, NY 10305-3034
Mailing address
97 New Dorp LN
Suite a
Staten Island, NY 10306-2359
Phone (718) 876-6220
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01072971 | Medicaid | NY | |
| 102286993 0001 | Medicaid | PA | |
| A400151565 | Other | NY | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden Gate Rehabilitation & Health Care Center LLC | Past | Accepting new patients |
Interoperability endpoints
- amiryazdani@imspllc.allscriptsdirect.net
Organizations & group practices 1
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.
-
- Skilled Nursing Facility
- Staten Island, NY
- NPI 1174510648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1295723922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 NEW DORP LN",
"address_2": "SUITE A",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103062359",
"telephone_number": "718-876-6220",
"fax_number": "718-876-5969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 SEAVIEW AVENUE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053034",
"telephone_number": "718-987-5940",
"fax_number": "718-667-9708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAZDANI",
"first_name": "AMIR",
"name_prefix": "Dr.",
"credential": "M. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-06",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "158890",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01072971",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102286993 0001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "A400151565",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.