Individual provider Active NPI

Yang Yang, RD

  • Registered Dietitian
  • Forest Hills, NY
National Provider Identifier
1578236550
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86023660 Issued in NY
Practice address
6841 Clyde St Apt a
Forest Hills, NY 11375-5037
Phone
(916) 214-2923
NPI assigned
Jul 27, 2021
Last updated
Jul 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X 86023660 NY
Registered Dietitian 133V00000X 86023660 NY Primary
Pediatric Nutrition Registered Dietitian 133VN1004X 86023660 NY
Pediatric Critical Care Nutrition Registered Dietitian 133VN1401X 86023660 NY

Addresses

Primary practice location

6841 Clyde St Apt a
Forest Hills, NY 11375-5037

Mailing address

6841 Clyde St Apt a
Forest Hills, NY 11375-5037

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EPIC Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230419002106 NY Practitioner - Registered Dietitian Or Nutrition Professional 3678948965 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86023660NYMDNutrition Education Nutritionist
009138NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Mar 1, 2023 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

1991 Marcus Ave
Ste M100
New Hyde Park, NY 11042
Phone (516) 472-3650

972 Brush Hollow Rd
Westbury, NY 11590

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1578236550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6841 CLYDE ST APT A",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6841 CLYDE ST APT A",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755037",
            "telephone_number": "916-214-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "YANG",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NY",
            "license": "86023660",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "86023660",
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NY",
            "license": "86023660",
            "primary": false
        },
        {
            "code": "133VN1401X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric Critical Care",
            "state": "NY",
            "license": "86023660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "PATIENT CARE",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PATIENT CARE",
            "address_1": "6841 Clyde St Apt A",
            "city": "Forest Hills",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113755037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.