Organization Active NPI

Thomas Youm MD LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Englewood, NJ
National Provider Identifier
1881456028
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
THOMAS YOUM MD LLC
Practice address
34 S Dean St Ste 202
Englewood, NJ 07631-3515
Phone
(212) 348-3636
NPI assigned
Jan 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Thomas Youm, MDNPI 1134116445
Title
MD
Phone
(212) 348-3636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

34 S Dean St Ste 202
Englewood, NJ 07631-3515

Mailing address

PO Box 56
Ithaca, NY 14851-0056
Phone (212) 348-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241217001948 NJ Part B Supplier - Clinic/Group Practice 2567805393 Receives reassigned benefits from 2 practitioners
Practice locations: Englewood, NJ

National Provider Directory

National Provider Directory

Locations

34 S Dean St
Ste 202
Englewood, NJ 07631
Phone (212) 348-3636

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1881456028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148510056",
            "telephone_number": "212-348-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 S DEAN ST STE 202",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076313515",
            "telephone_number": "212-348-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS YOUM MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "YOUM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "212-348-3636",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.