Individual provider Active NPI

Jenna Nicole Yang

  • Physician Assistant
  • Shawnee, KS
National Provider Identifier
1073372199
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6938 Roundtree St
Shawnee, KS 66226-3733
Phone
(703) 595-7128
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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 Primary

Addresses

Primary practice location

6938 Roundtree St
Shawnee, KS 66226-3733

Mailing address

6938 Roundtree St
Shawnee, KS 66226-3733
Phone (703) 595-7128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20260414002573 KS Practitioner - Physician Assistant 2163998501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11111 Nall Ave
Suite 103
Leawood, KS 66211-1625

PO Box
Suite 14368
Lenexa, KS 66285-4368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1073372199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6938 ROUNDTREE ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263733",
            "telephone_number": "703-595-7128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6938 ROUNDTREE ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263733",
            "telephone_number": "703-595-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "JENNA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

Verify at the official NPI Registry.