Individual provider Active NPI

Guang Yan Yao, PA-C

  • Physician Assistant
  • Elmhurst, NY
National Provider Identifier
1982009478
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018195 Issued in NY
Practice address
4008 Forley St
Elmhurst, NY 11373-1427
Phone
(718) 446-0270
NPI assigned
Oct 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 018195 NY Primary

Addresses

Primary practice location

4008 Forley St
Elmhurst, NY 11373-1427

Mailing address

14712 27TH Ave
Flushing, NY 11354-1435
Phone (347) 368-9226

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
I20181023001265 NY Practitioner - Physician Assistant 4981903150 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
018195NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Jun 30, 2020 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jun 30, 2020 Accepting new patients
Q All Care Medical PC PastSince Apr 1, 2020 Accepting new patients
Medical Care for You PC Physician Assistant PastSince Mar 22, 2020 Accepting new patients
Island Wide Medical Care PLLC PastSince Jun 11, 2023 Accepting new patients

Locations

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

Organizations & group practices 10

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": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1982009478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14712 27TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113541435",
            "telephone_number": "347-368-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 FORLEY ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731427",
            "telephone_number": "718-446-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAO",
        "first_name": "GUANG YAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.