Individual provider Active NPI

Stephen Wing Kin Yip

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1588185029
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F341615-1 Issued in NY
Practice address
7105 3Rd Ave
Brooklyn, NY 11209-1308
Phone
(718) 865-9333
NPI assigned
Jul 6, 2017
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F341615-1 NY Primary

Addresses

Primary practice location

7105 3Rd Ave
Brooklyn, NY 11209-1308

Mailing address

7105 3Rd Ave # 523
Brooklyn, NY 11209-1308
Phone (718) 865-9333

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031003373 NY Practitioner - Nurse Practitioner 4688940919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Living-at-Home Medical, PCGroup PAC ID 0244466217, 2 clinicians

Practice addresses (Care Compare)

6818 Madeline CT
Brooklyn, NY 11220-5807
Phone (718) 865-9333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F341615-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Living-at-Home Medical, PC CurrentSince Sep 1, 2017 Accepting new patients

Locations

7105 3rd Ave
Brooklyn, NY 11209
Phone (347) 251-8830

Networks

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

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": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1588185029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7105 3RD AVE # 523",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091308",
            "telephone_number": "718-865-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7105 3RD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091308",
            "telephone_number": "718-865-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIP",
        "first_name": "STEPHEN",
        "middle_name": "WING KIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-06",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341615-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.