Organization Active NPI

Yjh Medical PC

  • Internal Medicine Physician
  • Niagara Falls, NY
National Provider Identifier
1407248453
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
239582 Issued in NY
Legal business name
YJH MEDICAL PC
Practice address
1 Colomba Dr Ste 2
Niagara Falls, NY 14305-1275
Phone
(716) 501-5501
Fax
(716) 215-6400
NPI assigned
Feb 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Authorized official

Name
Mrs. Beth Macswan
Title
Office Manager
Phone
(716) 501-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 239582 NY Primary

Addresses

Primary practice location

1 Colomba Dr Ste 2
Niagara Falls, NY 14305-1275

Mailing address

1 Colomba Dr Ste 2
Niagara Falls, NY 14305-1275
Phone (716) 501-5501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150511000566 NY Part B Supplier - Clinic/Group Practice 2961721121 Receives reassigned benefits from 7 practitioners
Practice locations: Niagara Falls, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2300325Yjh Medical PC1 Colomba Drive Suite 2, Niagara Falls, NY 14305Certificate of waiverMar 6, 2028

National Provider Directory

National Provider Directory

Locations

4515 Military Rd
Niagara Falls, NY 14305
Phone (716) 236-7880

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1425081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1407248453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COLOMBA DR STE 2",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143051275",
            "telephone_number": "716-501-5501",
            "fax_number": "716-215-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLOMBA DR STE 2",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143051275",
            "telephone_number": "716-501-5501",
            "fax_number": "716-215-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YJH MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-28",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "MACSWAN",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "716-501-5501",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "239582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.