Individual provider Active NPI

Justin Yucht, DO

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Verona, NJ
National Provider Identifier
1912299579
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
25MB09847300 Issued in NJ
Practice address
271 Grove Ave Ste a
Verona, NJ 07044-1731
Phone
(973) 239-2600
Fax
(973) 239-8650
NPI assigned
May 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 25MB09847300 NJ Primary

Addresses

Primary practice location

271 Grove Ave Ste a
Verona, NJ 07044-1731

Mailing address

700 Route 46 E Ste 450
Fairfield, NJ 07004-1583
Phone (973) 559-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170501000837 NJ Practitioner - Physical Medicine and Rehabilitation 2860784683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Rowan University School of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanguard Medical Group PAGroup PAC ID 5092751842, 59 clinicians

Practice addresses (Care Compare)

271 Grove Ave
Suite a
Verona, NJ 07044-1731
Phone (973) 239-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care for the Homebound PA Current Accepting new patients
Vanguard Medical Group, PA Sports Medicine CurrentSince Jun 29, 2020 Accepting new patients

Locations

700 Route 46 E
Ste 450
Fairfield, NJ 07004
Phone (973) 559-3700

72 Hamburg Tpke
Ste B
Riverdale, NJ 07457
Phone (833) 488-1216

271 Grove Ave
Ste A
Verona, NJ 07044
Phone (973) 239-2600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25493/brand/1/csg/1/fhir/r4
  • Direct secure messaging: justin.yucht.1@25493.direct.athenahealth.com

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": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1912299579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ROUTE 46 E STE 450",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070041583",
            "telephone_number": "973-559-3700",
            "fax_number": "973-559-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 GROVE AVE STE A",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441731",
            "telephone_number": "973-239-2600",
            "fax_number": "973-239-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUCHT",
        "first_name": "JUSTIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-13",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NJ",
            "license": "25MB09847300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, NJ

Sources for this page

Verify at the official NPI Registry.