Individual provider Active NPI

Yuderqui J Checo, MD

  • Pediatrics Physician
  • Jackson Heights, NY
National Provider Identifier
1770601940
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
235118 Issued in NY
Practice address
93-20A Roosevelt Avenue
Suite 3a
Jackson Heights, NY 11372-7911
Phone
(718) 404-9109
Fax
(718) 404-9117
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 235118 NY Primary

Addresses

Primary practice location

93-20A Roosevelt Avenue
Suite 3a
Jackson Heights, NY 11372-7911

Mailing address

194 Hazelwood Dr
Westbury, NY 11590-1212
Phone (347) 813-8587

Other identifiers 1

IdentifierTypeStateIssuer
02665465MedicaidNY

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
235118NYMDPediatrics Physician

Networks

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

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1770601940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 HAZELWOOD DR",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901212",
            "telephone_number": "347-813-8587",
            "fax_number": "718-404-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93-20A ROOSEVELT AVENUE",
            "address_2": "SUITE 3A",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727911",
            "telephone_number": "718-404-9109",
            "fax_number": "718-404-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHECO",
        "first_name": "YUDERQUI",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "235118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02665465",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.