Individual provider Active NPI

Rajyalakshmi Yalla, M.D,

  • Family Medicine Physician
  • River Edge, NJ
National Provider Identifier
1467508309
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
208444 Issued in NY
Practice address
62 Lakeview St
River Edge, NJ 07661-1722
Phone
(201) 880-6537
Fax
(201) 880-6537
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 208444 NY Primary

Addresses

Primary practice location

62 Lakeview St
River Edge, NJ 07661-1722

Mailing address

62 Lakeview St
River Edge, NJ 07661-1722
Phone (201) 880-6537

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
I20110127000804 NY Practitioner - Family Practice 8123207750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1276 Fulton Ave
Bronx, NY 10456-3402

1650 Grand Concourse
Bronx, NY 10457-7606

Hospital & facility affiliations

  • Bronxcare Hospital Center Hospital, Bronx, NY, CCN 330009

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208444NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System Family Medicine CurrentSince Feb 11, 2013 Accepting new patients
Bronxcare Health System CurrentSince Feb 11, 2013 Accepting new patients
Bronxcare Health System Past Accepting new patients

Locations

1276 Fulton Ave
Rm 208
Bronx, NY 10456
Phone (718) 901-8918

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
Fl 3
Bronx, NY 10456
Phone (718) 901-8236

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467508309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 LAKEVIEW ST",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611722",
            "telephone_number": "201-880-6537",
            "fax_number": "201-880-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 LAKEVIEW ST",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611722",
            "telephone_number": "201-880-6537",
            "fax_number": "201-880-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YALLA",
        "first_name": "RAJYALAKSHMI",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "208444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Edge, NJ

Sources for this page

Verify at the official NPI Registry.