Active NPI
Olivia Yue
- Orthodontics and Dentofacial Orthopedics Dentistry
- New York, NY
National Provider Identifier
1497244701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 059972-1
- Practice address
- 550 1St Ave
New York, NY 10016-6402 - Phone
- (212) 263-5506
- NPI assigned
- May 2, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 059972-1 | NY | Primary |
Addresses
Primary practice location
550 1St Ave
New York, NY 10016-6402
Mailing address
32761 Jean Dr
Union City, CA 94587-5503
Phone (510) 304-7657
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180612003360 | CA | Order and Referring Only - Dentist | 0345595500 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 059972-1 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1497244701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32761 JEAN DR",
"city": "UNION CITY",
"state": "CA",
"postal_code": "945875503",
"telephone_number": "510-304-7657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100166402",
"telephone_number": "212-263-5506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUE",
"first_name": "OLIVIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-02",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "059972-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.