NPIMap

Organization Active NPI

Ydr Geriatrics & Nephrology LLP

  • Nephrology Physician
  • Bronx, NY
National Provider Identifier
1417020058
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
YDR GERIATRICS & NEPHROLOGY LLP
Practice address
4141 Carpenter Ave
Renal Unit
Bronx, NY 10466-2600
Phone
(718) 920-9041
Fax
(914) 633-5084
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Authorized official

Name
Dr. Jinil Yoo, MCNPI 1932283173
Title
Physician
Phone
(718) 920-9040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

4141 Carpenter Ave
Renal Unit
Bronx, NY 10466-2600

Mailing address

PO Box 1239
Scarsdale, NY 10583-9239
Phone (914) 263-7562

Other identifiers 3

IdentifierTypeStateIssuer
3300305OtherGHI
2672995OtherAETNA
00740818MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001916 NY Part B Supplier - Clinic/Group Practice 9234020983 Receives reassigned benefits from 7 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

4256 Bronx Blvd
Ste 3
Bronx, NY 10466
Phone (718) 690-3666

Practitioners & affiliated clinicians

Practitioners 12

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": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1417020058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105839239",
            "telephone_number": "914-263-7562",
            "fax_number": "914-633-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 CARPENTER AVE",
            "address_2": "RENAL UNIT",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662600",
            "telephone_number": "718-920-9041",
            "fax_number": "914-633-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YDR GERIATRICS & NEPHROLOGY LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "JINIL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "718-920-9040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MC"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "3300305",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2672995",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00740818",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.