Individual provider Active NPI

Yat Fan Chau

  • Adult Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1699479030
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2299715 Issued in NY
Practice address
932 Sinclair Ave
Staten Island, NY 10309-2231
Phone
(646) 617-1878
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2299715 NY Primary

Addresses

Primary practice location

932 Sinclair Ave
Staten Island, NY 10309-2231

Mailing address

932 Sinclair Ave
Staten Island, NY 10309-2231
Phone (646) 617-1878

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
I20230419000214 NY Practitioner - Nurse Practitioner 1759756000 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2299715NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Four Season Medical PLLC Adult Health CurrentSince Apr 1, 2023 Accepting new patients

Locations

837 59th St
Brooklyn, NY 11220
Phone (718) 975-8415

7112 Bay Pkwy
Brooklyn, NY 11204
Phone (718) 232-8500

837 59th St
Fl 5
Brooklyn, NY 11220
Phone (646) 532-7746

1836 Hylan Blvd
Staten Island, NY 10305
Phone (347) 896-5575

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1699479030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 SINCLAIR AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092231",
            "telephone_number": "646-617-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 SINCLAIR AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092231",
            "telephone_number": "646-617-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAU",
        "first_name": "YAT FAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "2299715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.