Bayside Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BAYSIDE PEDIATRICS PC

Practice address

4223 212TH St Ste 1a
Bayside, NY 11361-2987

Phone

(718) 229-7337

Fax

(718) 229-7333

NPI assigned

Jul 27, 2018

Organization subpart

No

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

Authorized official

Name

Yohan Park, MDNPI 1730220666

Title

Medical Doctor

Phone

(718) 229-7337

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yohan Park, MD

  • Pediatrics Physician
  • Bayside, NY
  • NPI 1730220666
  NPD (past) Authorized official
• Jieun Kim

  • Pediatric Nurse Practitioner
  • Fresno, CA
  • NPI 1386084333
  NPD (past)

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1720565187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4223 212TH ST STE 1A",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612987",
            "telephone_number": "718-229-7337",
            "fax_number": "718-229-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4223 212TH ST STE 1A",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612987",
            "telephone_number": "718-229-7337",
            "fax_number": "718-229-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-27",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "YOHAN",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "718-229-7337",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bayside Laser Dental PC
• Bayside Occupational Therapy PC
• Bayside Orthodontics PLLC
• Bayside Pediatric Care P.C.
• Bayside Pediatric Specialists P.C.
• Bayside Physical Therapy, Chiropractic & Acupuncture PLLC
• Bayside Professional PT PC
• Bayside Rehab PT PC
• Bayside RX LLC
• Bayside Speech & Language Pals, PLLC

• Pediatrics Physician in Bayside, NY
• Providers in Bayside, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.