Organization Active NPI

Northern Medical Services, PLLC

  • Plastic Surgery Physician
  • New York, NY
National Provider Identifier
1467145342
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
NORTHERN MEDICAL SERVICES, PLLC
Practice address
130 Fort Washington Ave
New York, NY 10032-4724
Phone
(630) 361-6267
Fax
(845) 625-1735
NPI assigned
May 29, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Dr. Jingduan Yang, MD
Title
Ceo
Phone
(973) 413-7990

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

130 Fort Washington Ave
New York, NY 10032-4724

Mailing address

14 Jason PL Ste 202
Middletown, NY 10940-1909
Phone (973) 413-7990

Other names 1

  • SY Aesthetics Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2292706Northern Medical Services PLLC130 Fort Washington Ave - Suite B1, New York, NY 10032Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

14 Jason Pl
Ste 202
Middletown, NY 10940
Phone (845) 410-2300

NPI Registry JSON

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

{
    "created_epoch": "1685318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1467145342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 JASON PL STE 202",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109401909",
            "telephone_number": "973-413-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100324724",
            "telephone_number": "630-361-6267",
            "fax_number": "845-625-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MEDICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-29",
        "last_updated": "2024-03-14",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "JINGDUAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-413-7990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SY Aesthetics",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SY Aesthetics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.