Active NPI
Jing Ja Yoon, M.D.
- Pediatrics Physician
- Bronx, NY
National Provider Identifier
1841375854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 115516-1
- Practice address
- 1650 Grand Concourse
Bronx, NY 10457-7606 - Phone
- (718) 579-2658
- Fax
- (718) 579-2659
- NPI assigned
- Oct 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 115516 | NY | |
| Pediatrics Physician | 208000000X | 115516-1 | NY | Primary |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 115516-1 | NY |
Addresses
Primary practice location
1650 Grand Concourse
Bronx, NY 10457-7606
Mailing address
1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 579-2658
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00213350 | Medicaid | NY |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115516-1 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335225600000",
"number": "1841375854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104577606",
"telephone_number": "718-579-2658",
"fax_number": "718-579-2659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104577606",
"telephone_number": "718-579-2658",
"fax_number": "718-579-2659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOON",
"first_name": "JING",
"middle_name": "JA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2012-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "115516",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "115516-1",
"primary": true
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "NY",
"license": "115516-1",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00213350",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.