Active NPI
Jenna Yoo, DO
- Pediatrics Physician
- Rochester, NY
National Provider Identifier
1386953156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 320862
- Practice address
- 601 Elmwood Ave # 777-R
Rochester, NY 14642-1641 - Phone
- (585) 275-4174
- NPI assigned
- Sep 28, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 320862 | NY | Primary |
Addresses
Primary practice location
601 Elmwood Ave # 777-R
Rochester, NY 14642-1641
Mailing address
1305 Prospect Ave
East Meadow, NY 11554-4742
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200923000905 | NY | Order and Referring Only - Pediatric Medicine | 2668661786 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014258 | NY | MD | Mental Health Counselor |
| 320862 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PM Pediatrics of Mamaroneck | Past | Accepting new patients | |
| Zhanna Roit, M.D. P.C | Past | Accepting new patients | |
| PM Pediatrics PC | Pediatrics | Past | Accepting new patients |
| D.a.C. Physical Medicine, P.C. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Great Neck, NY
- NPI 1871821504
-
- Urgent Care Clinic/Center
- Mamaroneck, NY
- NPI 1073645180
-
- Physical Medicine & Rehabilitation Physician
- Great Neck, NY
- NPI 1144266941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687564800000",
"number": "1386953156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 PROSPECT AVE",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "115544742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 ELMWOOD AVE # 777-R",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146421641",
"telephone_number": "585-275-4174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOO",
"first_name": "JENNA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-28",
"last_updated": "2023-06-24",
"certification_date": "2023-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "320862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.