Individual provider Active NPI

Yeahseon Choi Bruinings, MD

  • Family Medicine Physician
  • Bayside, NY
National Provider Identifier
1770580235
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
226709 Issued in NY
Practice address
3438 Bell Blvd
PH Floor 5
Bayside, NY 11361-1730
Phone
(718) 360-5768
Fax
(718) 224-5885
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 226709 NY Primary

Addresses

Primary practice location

3438 Bell Blvd
PH Floor 5
Bayside, NY 11361-1730

Mailing address

3438 Bell Blvd
PH Floor 5
Bayside, NY 11361-1730
Phone (718) 360-5768

Other identifiers 1

IdentifierTypeStateIssuer
02405338MedicaidNY

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
I20041115001037 NY Practitioner - Family Practice 1658335161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3438 Bell Blvd
PH Floor5
Bayside, NY 11361-1739
Phone (718) 360-5768

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226709NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yeahseon Bruinings MD Family Practice PLLC Family Medicine CurrentSince Jul 1, 2004 Accepting new patients

Locations

3438 Bell Blvd
Ste 5
Bayside, NY 11361
Phone (718) 360-5768

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HIJIAA/Endpoint/HIJIAA

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1770580235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3438 BELL BLVD",
            "address_2": "PH FLOOR 5",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611730",
            "telephone_number": "718-360-5768",
            "fax_number": "718-224-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3438 BELL BLVD",
            "address_2": "PH FLOOR 5",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611730",
            "telephone_number": "718-360-5768",
            "fax_number": "718-224-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUININGS",
        "first_name": "YEAHSEON",
        "middle_name": "CHOI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "226709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02405338",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.