Individual provider Active NPI

Yinabeth Tallaj

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1669091716
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
333094 Issued in NY
Practice address
610 Academy St Ste 10a
New York, NY 10034-5058
Phone
(833) 717-2828
Fax
(347) 625-6551
NPI assigned
Apr 9, 2020
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 333094 NY Primary

Addresses

Primary practice location

610 Academy St Ste 10a
New York, NY 10034-5058

Mailing address

571 Academy St Apt 1a
New York, NY 10034-5105
Phone (833) 717-2828

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118001214 NY Practitioner - Internal Medicine 9133653892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somos Medical PCGroup PAC ID 6406217868, 10 clinicians

Practice addresses (Care Compare)

1030 Sheridan Ave
Bronx, NY 10456-6100
Phone (833) 717-2828

1150 Webster Ave
Bronx, NY 10456-1834
Phone (833) 717-2828

44 Sherman Ave
New York, NY 10040-1104
Phone (833) 717-2828

571 Academy St
Apt 1a
New York, NY 10034-5105

610 Academy St
Suite 10a
New York, NY 10034-5058
Phone (833) 717-2828

620 W 190TH St
New York, NY 10040-4157
Phone (833) 717-2828

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
333094NYMDInternal Medicine Physician

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • 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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1669091716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 ACADEMY ST APT 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100345105",
            "telephone_number": "833-717-2828",
            "fax_number": "347-625-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 ACADEMY ST STE 10A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100345058",
            "telephone_number": "833-717-2828",
            "fax_number": "347-625-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLAJ",
        "first_name": "YINABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "333094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.