Individual provider Active NPI

Zvi Steve Yadin, PH.D. NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Smithtown, NY
National Provider Identifier
1821178476
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F400794-1 Issued in NY
Practice address
21 Redwood LN
Smithtown, NY 11787-2718
Phone
(631) 360-3330
Fax
(631) 297-8444
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 011739-1 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F400794-1 NY Primary
Registered Nurse 163W00000X 533159 NY
Adult Health Nurse Practitioner 363LA2200X F305760-1 NY

Addresses

Primary practice location

21 Redwood LN
Smithtown, NY 11787-2718

Mailing address

21 Redwood LN
Smithtown, NY 11787-2718
Phone (631) 360-3330

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
I20070829000477 NY Practitioner - Nurse Practitioner 5991705527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21 Redwood LN
Smithtown, NY 11787-2718
Phone (631) 360-3330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
003532CTMDClinical Psychologist
400794NYMDRegistered Nurse
533159NYMDRegistered Nurse
011739-1NYMDPediatric Occupational Therapist
F305760-1NYMDAdult Health Nurse Practitioner
F400794-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Psychiatric Services - NP in Psychiatry, PLLC Psychiatric/Mental Health CurrentSince Jun 1, 2015 Accepting new patients
Stony Brook Psychiatric Associates, University Faculty Practice Corpor PastSince Jul 23, 2015 Accepting new patients

Locations

21 Redwood Ln
Smithtown, NY 11787
Phone (631) 360-3330

Organizations & group practices 2

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1821178476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 REDWOOD LN",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872718",
            "telephone_number": "631-360-3330",
            "fax_number": "631-297-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 REDWOOD LN",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872718",
            "telephone_number": "631-360-3330",
            "fax_number": "631-297-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADIN",
        "first_name": "ZVI",
        "middle_name": "STEVE",
        "name_prefix": "Dr.",
        "credential": "PH.D. NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011739-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400794-1",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "533159",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305760-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.