Active NPI
Wayne A. Yankus, M.D.
- Specialist
- Ridgewood, NJ
National Provider Identifier
1376502484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA36121
- Practice address
- 358 Evergreen PL
Ridgewood, NJ 07450-4515 - Phone
- (201) 637-3569
- NPI assigned
- Mar 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA36121 | NJ | Primary |
Addresses
Primary practice location
358 Evergreen PL
Ridgewood, NJ 07450-4515
Mailing address
358 Evergreen PL
Ridgewood, NJ 07450-4515
Phone (201) 637-3569
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA36121 | NJ | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379635200000",
"number": "1376502484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "358 EVERGREEN PL",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074504515",
"telephone_number": "201-637-3569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "358 EVERGREEN PL",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074504515",
"telephone_number": "201-637-3569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANKUS",
"first_name": "WAYNE",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-20",
"last_updated": "2013-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "MA36121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.