Michael Ishu Yang, M.D.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

A112702 Issued in CA

Practice address

392 Tesconi CT
Santa Rosa, CA 95401-4653

Phone

(707) 623-9803

Fax

(707) 843-3257

NPI assigned

Oct 29, 2008

Last updated

Apr 15, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

AnesthesiologyAlso: Interventional Pain Management, Pain Management

Education

University of California, San Francisco School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Pain Alliance IncGroup PAC ID 5890962138, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Merit-based Incentive Payment System (MIPS)

Final score

14.31 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

47.71

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Pain Alliance Inc

  • Specialist
  • Santa Rosa, CA
  • NPI 1558630020
  Medicare reassignment Care Compare group NPD Authorized official
• Petaluma Specialty Center, LLC.

  • Ambulatory Surgical Clinic/Center
  • Petaluma, CA
  • NPI 1528576675
  NPD Authorized official
• Summit Pain Alliance Inc

  • Specialist
  • Petaluma, CA
  • NPI 1538559018
  NPD Authorized official
• Acadia Pain Management Group, Inc.

  • Pain Medicine Physician
  • Santa Rosa, CA
  • NPI 1154630044
  NPD (past)
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523750400000",
    "number": "1063665438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 TESCONI CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014653",
            "telephone_number": "707-623-9803",
            "fax_number": "707-843-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 TESCONI CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014653",
            "telephone_number": "707-623-9803",
            "fax_number": "707-843-3257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 Lynch Creek Way",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949542342",
            "country_code": "US",
            "telephone_number": "707-623-9803",
            "fax_number": "707-843-3257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1456 Professional Dr Ste 404",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949546639",
            "country_code": "US",
            "telephone_number": "707-981-7995",
            "fax_number": "707-981-7912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "MICHAEL",
        "middle_name": "ISHU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-29",
        "last_updated": "2018-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A112702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "EV430X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yan Kalika Dental Corporation (Smile Country Dental)
• Yan Kalika DMD Ms Inc (SmileBliss)
• Diana Alexandra Yanez
• Jennifer Yang
• Lillian Yang, MD
• Scott Hosung Yang, MD
• Shu Qing Yang, MD
• Wanhua Yang, M.D. PH.D.
• Dennis Howard Yarnell, M.A. M.F.T.
• Ali Yassen, M.D.

• Pain Medicine (Anesthesiology) Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.