Individual provider Active NPI

Tony Yan, MD

  • Otolaryngology Physician
  • Baltimore, MD
National Provider Identifier
1073567129
Registry record updated Aug 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MDD002366018 Issued in MD
Practice address
6700 Ridge Rd
Suite 3
Baltimore, MD 21237
Phone
(410) 391-3434
Fax
(410) 574-7574
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MDD002366018 MD Primary

Addresses

Primary practice location

6700 Ridge Rd
Suite 3
Baltimore, MD 21237

Mailing address

6700 Ridge Rd
Suite 3
Baltimore, MD 21237-3960
Phone (410) 391-3434

Other identifiers 1

IdentifierTypeStateIssuer
781651100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MDD002366018MDMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313193600000",
    "number": "1073567129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 RIDGE RD",
            "address_2": "SUITE 3",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373960",
            "telephone_number": "410-391-3434",
            "fax_number": "410-574-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 RIDGE RD",
            "address_2": "SUITE 3",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21237",
            "telephone_number": "410-391-3434",
            "fax_number": "410-574-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "TONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2011-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "MDD002366018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "781651100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.