Young Joo Yeo, M.D.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

130869 Issued in NY

Practice address

452 Suffolk Ave
Access/Acceso
Brentwood, NY 11717

Phone

(631) 436-6065

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Outreach Development Corporation

  • Addiction (Substance Use Disorder) Counselor
  • Richmond Hill, NY
  • NPI 1083717326
  NPD (past)
• Town of Islip

  • Addiction (Substance Use Disorder) Counselor
  • Brentwood, NY
  • NPI 1215029004
  NPD (past)
• Town of Islip

  • Addiction (Substance Use Disorder) Counselor
  • Islip, NY
  • NPI 1548369143
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881774636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 TIMBER RIDGE DR",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117251739",
            "telephone_number": "631-269-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 SUFFOLK AVE",
            "address_2": "ACCESS/ACCESO",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "11717",
            "telephone_number": "631-436-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEO",
        "first_name": "YOUNG JOO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "130869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE MEDICAL LICENSE",
            "identifier": "130869",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Akisha Wilson, NP
• Peter Winston
• Bianca M. Wisdom
• William James Wisniewski, L.C.S.W
• Joseph Xerri, M.D.
• Susan Yost, LPN
• Lilia L Zablan, MD
• David Peter Zaccaro
• Dawn Loretta Zaffuto
• Elizabeth Zamajtys

• Community/Behavioral Health Agency in Brentwood, NY
• Providers in Brentwood, NY by specialty
• Community/Behavioral Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.