Eric Joel Yagual

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

108112-01 Issued in NY

Practice address

8802 Rockaway Beach Blvd
Rockaway Beach, NY 11693-1609

Phone

(718) 634-3461

NPI assigned

Jun 10, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Fordham University School of Medicine, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Outreach Development Corporation

  • Addiction (Substance Use Disorder) Counselor
  • Richmond Hill, NY
  • NPI 1083717326
  Medicare reassignment NPD

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1649847377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13021 116TH ST",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202321",
            "telephone_number": "917-428-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8802 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY BEACH",
            "state": "NY",
            "postal_code": "116931609",
            "telephone_number": "718-634-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGUAL",
        "first_name": "ERIC",
        "middle_name": "JOEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "108112-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barriella Wertheimer, CRPA
• Melanie Willis
• Emilia Wojcik
• Woodmere Medical PC
• Jodi Yaeger
• Kyi Win Yu, MD
• Daniel J Zeidman, MD

• Mental Health Counselor in Rockaway Beach, NY
• Providers in Rockaway Beach, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.