Individual provider Active NPI

Lauren Rae Yanez, PA-C

  • Obstetrics & Gynecology Physician
  • Avondale, AZ
National Provider Identifier
1073075123
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
7955 Issued in AZ
Practice address
10815 W McDowell Rd Ste 301
Avondale, AZ 85392-5016
Phone
(623) 535-0740
Fax
(623) 535-0741
NPI assigned
Apr 5, 2019
Last updated
Jul 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7955 AZ
Obstetrics & Gynecology Physician 207V00000X 7955 AZ Primary

Addresses

Primary practice location

10815 W McDowell Rd Ste 301
Avondale, AZ 85392-5016

Mailing address

PO Box 25317
Tampa, FL 33622-5317
Phone (813) 286-0033

Other practice location 1

9130 W Thomas Rd Ste A-108
Phoenix, AZ 85037-3377
Phone (623) 433-0106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200817003898 AZ Practitioner - Physician Assistant 1759707037 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7955AZMDPhysical Therapist

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1073075123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25317",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336225317",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 W MCDOWELL RD STE 301",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925016",
            "telephone_number": "623-535-0740",
            "fax_number": "623-535-0741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9130 W Thomas Rd Ste A-108",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850373377",
            "country_code": "US",
            "telephone_number": "623-433-0106",
            "fax_number": "623-433-0107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANEZ",
        "first_name": "LAUREN",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7955",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "7955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.