Individual provider Active NPI

Diane Y Jang

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1093270944
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12596 Issued in TX
Practice address
7400 Fannin St Ste 855
Houston, TX 77054-1951
Phone
(713) 796-9466
Fax
(713) 796-9467
NPI assigned
Feb 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA12596 TX Primary

Addresses

Primary practice location

7400 Fannin St Ste 855
Houston, TX 77054-1951

Mailing address

7400 Fannin St Ste 855
Houston, TX 77054-1951
Phone (713) 796-9466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260516000293 GA Practitioner - Physician Assistant 0941541627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Baylor College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3495 Piedmont Rd NE
Building 9 1St Floor
Atlanta, GA 30505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA12596TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Primary Care of California PC Single Specialty PastSince Feb 25, 2021 Accepting new patients

Organizations & group practices 2

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": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1093270944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 FANNIN ST STE 855",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770541951",
            "telephone_number": "713-796-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 FANNIN ST STE 855",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770541951",
            "telephone_number": "713-796-9466",
            "fax_number": "713-796-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "DIANE",
        "middle_name": "Y",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.