Individual provider Active NPI

Yang Jing, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1407516453
Registry record updated May 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009502 Issued in NY
Practice address
517 E 117TH St
New York, NY 10035-4409
Phone
(212) 896-5886
Fax
(212) 896-5887
NPI assigned
Dec 17, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009502 NY Primary

Addresses

Primary practice location

517 E 117TH St
New York, NY 10035-4409

Mailing address

517 E 117TH St
New York, NY 10035-4409
Phone (857) 384-0312

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220401001562 NY Practitioner - Optometry 5496141335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

517 E 117TH St
New York, NY 10035-4409
Phone (212) 896-5886

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009502NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eye Physician PLLC Optometrist CurrentSince Mar 5, 2022 Accepting new patients
Jing Yang Vision Source Inc Optometrist CurrentSince Feb 2, 2025 Accepting new patients
Ny Blinks Optometry Eye Care P.C. Optometrist CurrentSince Nov 1, 2024 Accepting new patients
Grand Fashion Optical, Inc Optometrist CurrentSince Dec 1, 2021 Accepting new patients

Locations

4270 Kissena Blvd
Flushing, NY 11355
Phone (718) 888-9838

517 E 117th St
New York, NY 10035
Phone (212) 896-5886

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.

NPI Registry JSON

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746316800000",
    "number": "1407516453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 E 117TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100354409",
            "telephone_number": "857-384-0312",
            "fax_number": "212-896-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 E 117TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100354409",
            "telephone_number": "212-896-5886",
            "fax_number": "212-896-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JING",
        "first_name": "YANG",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-17",
        "last_updated": "2025-05-04",
        "certification_date": "2025-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.