Individual provider Active NPI

William C Yu, MD

  • Pediatrics Physician
  • Jersey City, NJ
National Provider Identifier
1407852056
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA05798000 Issued in NJ
Practice address
377 Jersey Ave
Suite 420
Jersey City, NJ 07302-4393
Phone
(201) 333-0003
Fax
(201) 333-0006
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA05798000 NJ Primary

Addresses

Primary practice location

377 Jersey Ave
Suite 420
Jersey City, NJ 07302-4393

Mailing address

377 Jersey Ave
Suite 420
Jersey City, NJ 07302-4393
Phone (201) 333-0003

Other identifiers 1

IdentifierTypeStateIssuer
5258405MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20171130003226 NJ Practitioner - Pediatric Medicine 1658638549 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare , LLC CurrentSince Jan 2, 2018 Accepting new patients
Advocare, LLC Pediatrics CurrentSince Jan 2, 2018 Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1407852056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 JERSEY AVE",
            "address_2": "SUITE 420",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024393",
            "telephone_number": "201-333-0003",
            "fax_number": "201-333-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 JERSEY AVE",
            "address_2": "SUITE 420",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024393",
            "telephone_number": "201-333-0003",
            "fax_number": "201-333-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05798000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5258405",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.