NPIMap

Individual provider Active NPI

Fan Jim Yang, MD

  • Emergency Medicine Physician
  • Bronx, Ny, NY
National Provider Identifier
1457819559
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
322001 Issued in NY
Practice address
1400 Pelham Pkwy S
Building 6/ Suite B125
Bronx, Ny, NY 10461
Phone
(718) 918-5820
NPI assigned
Mar 7, 2019
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 322001 NY Primary

Addresses

Primary practice location

1400 Pelham Pkwy S
Building 6/ Suite B125
Bronx, Ny, NY 10461

Mailing address

600 S Paulina St
Chicago, IL 60612-3806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230522000270 NY Practitioner - Emergency Medicine 8820454606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

525 E 68TH St
Emergency Physicians Dept
New York, NY 10021-4870
Phone (646) 962-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 1, 2023 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2025 Accepting new patients
Weill Medical College of Cornell Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
New York University Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Jacobi Medical Center Ed Past Accepting new patients

Locations

170 William St
New York, NY 10038
Phone (212) 238-0100

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1457819559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "address_2": "BUILDING 6/ SUITE B125",
            "city": "BRONX, NY",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "718-918-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "FAN",
        "middle_name": "JIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-07",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "322001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, Ny, NY

Sources for this page

Verify at the official NPI Registry.