Individual provider Active NPI

Yi Ding, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Roswell, GA
National Provider Identifier
1114309267
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
89733 Issued in GA
Practice address
490 Sun Valley Dr Ste 103
Roswell, GA 30076-5642
Phone
(678) 490-2255
Fax
(678) 799-7593
NPI assigned
Jun 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 89733 GA
Physical Medicine & Rehabilitation Physician 208100000X 0102204647 VA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 0102204647 VA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 89733 GA Primary

Addresses

Primary practice location

490 Sun Valley Dr Ste 103
Roswell, GA 30076-5642

Mailing address

490 Sun Valley Dr Ste 103
Roswell, GA 30076-5642
Phone (678) 490-2255

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210818002040 GA Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 0941506976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Ohio University, College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

490 Sun Valley Dr
Suite 103
Roswell, GA 30076-5642
Phone (678) 490-2255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89733GAMDPain Medicine (Physical Medicine & Rehabilitation) Physician
0102204647VAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Painlogics LLC CurrentSince Sep 19, 2023 Accepting new patients

Locations

490 Sun Valley Dr
Ste 103
Roswell, GA 30076
Phone (678) 490-2255

Interoperability endpoints

  • Direct secure messaging: yi.ding.1@30118.direct.athenahealth.com

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1114309267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 SUN VALLEY DR STE 103",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765642",
            "telephone_number": "678-490-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 SUN VALLEY DR STE 103",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765642",
            "telephone_number": "678-490-2255",
            "fax_number": "678-799-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DING",
        "first_name": "YI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "89733",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0102204647",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0102204647",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "89733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.