Individual provider Active NPI

Yuan Yuan Huang, PA-C

  • Physician Assistant
  • Fresh Meadows, NY
National Provider Identifier
1720331556
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
23 016127 Issued in NY
Practice address
133-47 Sanford Avenue Suite C1G
Fresh Meadows, NY 11365-1522
Phone
(646) 206-1107
NPI assigned
Oct 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 23 016127 NY Primary

Addresses

Primary practice location

133-47 Sanford Avenue Suite C1G
Fresh Meadows, NY 11365-1522

Mailing address

5829 182ND St
Fresh Meadows, NY 11365-1522
Phone (646) 206-1107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
016127NYMDClinical Psychologist
23 016127NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ae&Ly Ambulatory Endoscopy PLLC PastSince Oct 18, 2009 Accepting new patients

Networks

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

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": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1720331556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5829 182ND ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651522",
            "telephone_number": "646-206-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133-47 SANFORD AVENUE SUITE C1G",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651522",
            "telephone_number": "646-206-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "YUAN YUAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "23 016127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.