Individual provider Active NPI

Yijun Yang, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Syracuse, NY
National Provider Identifier
1508868936
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
205322 Issued in NY
Practice address
1226 E Water St
Syracuse, NY 13210-1155
Phone
(315) 558-6641
Fax
(315) 703-7902
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 205322 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 205322 NY Primary

Addresses

Primary practice location

1226 E Water St
Syracuse, NY 13210-1155

Mailing address

1226 E Water St
Syracuse, NY 13210-1155
Phone (315) 478-4185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205322NYMDCytopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Past Accepting new patients
Digestive Disease Medicine of Central New York, LLP PastSince Jul 1, 1995 Accepting new patients

Organizations & group practices 2

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1508868936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 E WATER ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101155",
            "telephone_number": "315-478-4185",
            "fax_number": "315-478-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 E WATER ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101155",
            "telephone_number": "315-558-6641",
            "fax_number": "315-703-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "YIJUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NY",
            "license": "205322",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "205322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.