Individual provider Active NPI

Haijun Yao, NP

  • Family Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1972135374
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
345195 Issued in NY
Practice address
4979 Harlem Rd
Buffalo, NY 14226-2547
Phone
(716) 923-4380
Fax
(716) 923-4384
NPI assigned
Feb 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 345195 NY Primary

Addresses

Primary practice location

4979 Harlem Rd
Buffalo, NY 14226-2547

Mailing address

4979 Harlem Rd
Buffalo, NY 14226-2547
Phone (716) 923-4380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200402001617 NY Practitioner - Nurse Practitioner 4284063884 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wny Medical PCGroup PAC ID 9335191733, 44 clinicians

Practice addresses (Care Compare)

4979 Harlem Rd
Amherst, NY 14226-2547
Phone (716) 923-4380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
345195NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Niagara Falls Memorial Medical Center CurrentSince May 1, 2022 Accepting new patients
Wny Medical PC Family CurrentSince Mar 1, 2020 Accepting new patients
Academic Medicine Services, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince May 1, 2022 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Jul 1, 2022 Accepting new patients

Locations

15 Northland Ave
Buffalo, NY 14208
Phone (585) 797-5828

462 Grider St
Fl 11
Buffalo, NY 14215
Phone (716) 898-4803

4979 Harlem Rd
Buffalo, NY 14226
Phone (716) 923-4380

135 Grant St
Buffalo, NY 14213
Phone (716) 881-4300

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

2600 S Park Ave
Lackawanna, NY 14218
Phone (716) 822-2028

620 10th St
Ste 704
Niagara Falls, NY 14301
Phone (716) 278-4402

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/

Organizations & group practices 5

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": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1972135374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4979 HARLEM RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142262547",
            "telephone_number": "716-923-4380",
            "fax_number": "716-923-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4979 HARLEM RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142262547",
            "telephone_number": "716-923-4380",
            "fax_number": "716-923-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAO",
        "first_name": "HAIJUN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.