Individual provider Active NPI

John G Yuan, M.D.

  • Vascular Surgery Physician
  • Manhasset, NY
National Provider Identifier
1336163336
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
199162-1 Issued in NY
Practice address
1129 Northern Blvd Ste 307
Manhasset, NY 11030-3022
Phone
(516) 498-3800
Fax
(516) 498-3801
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 199162-1 NY Primary

Addresses

Primary practice location

1129 Northern Blvd Ste 307
Manhasset, NY 11030-3022

Mailing address

1129 Northern Blvd Ste 307
Manhasset, NY 11030-3022
Phone (516) 498-3800

Other identifiers 1

IdentifierTypeStateIssuer
01864557MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080605000433 NY Practitioner - Vascular Surgery 4486724275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Icahn School of Medicine at Mount Sinai, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1129 Northern Blvd
Suite 307
Manhasset, NY 11030-3022
Phone (516) 498-3800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal810
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
199162-1NYMDVascular Surgery Physician

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DBADCA/Endpoint/DBADCA

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1336163336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 NORTHERN BLVD STE 307",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303022",
            "telephone_number": "516-498-3800",
            "fax_number": "516-498-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 NORTHERN BLVD STE 307",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303022",
            "telephone_number": "516-498-3800",
            "fax_number": "516-498-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUAN",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "199162-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01864557",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.