Individual provider Active NPI

Jay Wallace Yeager, COTA

  • Specialist
  • Placentia, CA
National Provider Identifier
1962696575
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OTA318 Issued in CA
Practice address
101 S Kraemer Blvd Ste 206
Placentia, CA 92870-6110
Phone
(714) 961-8288
NPI assigned
Aug 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OTA318 CA Primary

Addresses

Primary practice location

101 S Kraemer Blvd Ste 206
Placentia, CA 92870-6110

Mailing address

101 S Kraemer Blvd Ste 206
Placentia, CA 92870-6110
Phone (714) 961-8288

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110609000250 CA Practitioner - Occupational Therapist in Private Practice 6002093564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hands on Hands Rehabilitation Center, IncGroup PAC ID 5991731655, 4 clinicians

Practice addresses (Care Compare)

1700 Adams Ave
Costa Mesa, CA 92626-4865
Phone (714) 556-2288

4772 Katella Ave
Suite 100
Los Alamitos, CA 90720-2681
Phone (562) 430-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTA318CAMDSpecialist
318CAMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Hands on Hands Rehabilitation Center, Inc CurrentSince Apr 23, 2011 Accepting new patients
Hands on Hands Rehabilitation Center, Inc. Past Accepting new patients

Locations

1700 Adams Ave
Ste 103
Costa Mesa, CA 92626
Phone (714) 556-2288

Interoperability endpoints

  • Direct secure messaging: jay.yeager.p46@direct.newportmed.nextgenshare.com
  • Direct secure messaging: jay.yeager.p29@direct.newportmed.nextgenshare.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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1962696575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S KRAEMER BLVD STE 206",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706110",
            "telephone_number": "714-961-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S KRAEMER BLVD STE 206",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706110",
            "telephone_number": "714-961-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAGER",
        "first_name": "JAY",
        "middle_name": "WALLACE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "OTA318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.