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BAYSIDE PEDIATRICS PC
NPI 1720565187
Pediatrics in Bayside, NY

Active since July 27, 2018CLIA 33D2168065 · Waiver
4223 212TH ST STE 1A, BAYSIDE, NY 11361(718) 229-7337(718) 229-7333 Get Directions Write a Review

NPPES record last updated: January 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 21, 2022, Jul 27, 2018 (2 updates tracked since 2018).

About Bayside Pediatrics Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BAYSIDE PEDIATRICS PC (NPI 1720565187) is a healthcare organization registered as a pediatrics in Bayside, New York and active in the NPI registry since July 2018. The organization holds a CLIA Waiver certificate valid through September 23, 2027 and lists Yohan Park, Medical Doctor, as its authorized official.

NPPES Registry Identity

NPI1720565187
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameBAYSIDE PEDIATRICS PC
Location Address4223 212TH ST STE 1ABayside, NY 11361-2987
Mailing Address4223 212th St Ste 1aBayside, NY 11361-2987 · (718) 229-7337 · Fax (718) 229-7333
Phone(718) 229-7337
Fax(718) 229-7333
Organization SubpartNo
Authorized OfficialYohan ParkMedical Doctor · (718) 229-7337
Enumeration DateJuly 27, 2018
Last NPPES UpdateJanuary 21, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 21, 2022
✔ NPI 1720565187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
4223 212TH ST STE 1A, Bayside, NY 11361
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2168065

Bayside Pediatrics PC · Bayside, NY
Active · expires Sep 23, 2027
CLIA Number33D2168065
Laboratory TypeHealth Fair
Certificate Effective DateSeptember 24, 2025
Certificate Expiration DateSeptember 23, 2027
Laboratory DirectorDr. Yohan Park
Laboratory Phone(718) 229-7337
Laboratory LocationBayside Pediatrics PC42-23 212th Street Unit 1A, Bayside, NY 11361
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bayside Pediatrics PC's NPI number?

The NPI number for Bayside Pediatrics PC is 1720565187. It was assigned to this organization in the NPPES registry on July 27, 2018.

Where is Bayside Pediatrics PC located?

Bayside Pediatrics PC is located at 4223 212th St Ste 1A, Bayside, NY 11361. The listed phone number is (718) 229-7337.

What is Bayside Pediatrics PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Bayside Pediatrics PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2168065) is associated with this NPI, valid through September 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bayside Pediatrics PC was last updated on January 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.