Individual provider Active NPI

Christina M Yambo, MD

  • Emergency Medicine Physician
  • Syracuse, NY
National Provider Identifier
1457319352
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D80059 Issued in NY
Practice address
475 Irving Ave
Suite 200
Syracuse, NY 13210-1756
Phone
(315) 464-4686
Fax
(315) 464-7106
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 234490 NY
Emergency Medicine Physician 207P00000X D80059 NY Primary

Addresses

Primary practice location

475 Irving Ave
Suite 200
Syracuse, NY 13210-1756

Mailing address

475 Irving Ave
Suite 200
Syracuse, NY 13210-1756
Phone (315) 464-4686

Other identifiers 1

IdentifierTypeStateIssuer
02682584MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051026000716 NY Practitioner - Family Practice 2264458728 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D80059NYMDEmergency Medicine Physician
234490NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Nov 9, 2016 Accepting new patients
Ny Primary Care Practice PC Family Medicine CurrentSince Nov 9, 2016 Accepting new patients
Christian L Holcomb, MD Family Medicine PastSince Nov 15, 2012 Accepting new patients
Family Medicine Medical Service Group Family Medicine PastSince Jul 23, 2015 Accepting new patients
Upstate Family and Preventive Medicine, Inc Family Medicine PastSince Mar 5, 2016 Accepting new patients
Immediate Care East Walk-in Medical Treatment, PLLC PastSince May 1, 2007 Accepting new patients
Syracuse Community Health Center, Inc. Past Accepting new patients
Ny Urgent Care Practice, P.C. PastSince Apr 1, 2014 Accepting new patients

Locations

8003 Brewerton Rd
Cicero, NY 13039
Phone (315) 288-4006

830 County Road 64
#19C
Elmira, NY 14903
Phone (607) 846-2030

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#2
Liverpool, NY 13090
Phone (315) 291-0064

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

Organizations & group practices 8

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1457319352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE",
            "address_2": "SUITE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101756",
            "telephone_number": "315-464-4686",
            "fax_number": "315-464-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE",
            "address_2": "SUITE 200",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101756",
            "telephone_number": "315-464-4686",
            "fax_number": "315-464-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMBO",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "234490",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "D80059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02682584",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.