Individual provider Active NPI

Serena Yang, MD, MPH

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1073693321
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A101567 Issued in CA
Practice address
4600 Broadway
Sacramento, CA 95820-1527
Phone
(916) 874-9670
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A101567 CA Primary

Addresses

Primary practice location

4600 Broadway
Sacramento, CA 95820-1527

Mailing address

2516 Stockton Blvd
Sacramento, CA 95817-2208
Phone (916) 734-5387

Other practice location 1

2521 Stockton Blvd Ste 2304B
Sacramento, CA 95817-2207
Phone (916) 734-3112

Other identifiers 1

IdentifierTypeStateIssuer
164755401MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101203000044 CA Practitioner - Pediatric Medicine 0244211415 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A101567CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacramento Native American Health Center Inc CurrentSince Oct 1, 2020 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 19, 2020 Accepting new patients
County of Sacramento CurrentSince Sep 3, 2020 Accepting new patients
County of Sacramento CurrentSince Sep 3, 2020 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 19, 2020 Accepting new patients
University Faculty Associates, Inc. Past Accepting new patients
Texas Children'S Physician Group Pediatrics Past Accepting new patients

Locations

4600 Broadway
#1100
Sacramento, CA 95820
Phone (916) 874-9670

2521 Stockton Blvd
Ste 2200
Sacramento, CA 95817
Phone (916) 734-1180

2020 J St
Sacramento, CA 95811
Phone (916) 341-0575

2521 Stockton Blvd
Ste 2304B
Sacramento, CA 95817
Phone (916) 734-3112

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

4600 Broadway
Sacramento, CA 95820
Phone (916) 874-9670

Interoperability endpoints

  • Direct secure messaging: syang318712@direct.ochin.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1073693321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172208",
            "telephone_number": "916-734-5387",
            "fax_number": "916-456-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 BROADWAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201527",
            "telephone_number": "916-874-9670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2521 Stockton Blvd Ste 2304B",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172207",
            "country_code": "US",
            "telephone_number": "916-734-3112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "SERENA",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A101567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164755401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.