Individual provider Active NPI

Qi Yan

  • Surgery Physician
  • San Antonio, TX
National Provider Identifier
1114450616
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
32678 Issued in MS
Practice address
4502 Medical Dr.
University Health System Professional Staff Services
San Antonio, TX 78229
Phone
(210) 567-5711
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 32678 MS Primary

Addresses

Primary practice location

4502 Medical Dr.
University Health System Professional Staff Services
San Antonio, TX 78229

Mailing address

128 Highland Pkwy Ste 201
Picayune, MS 39466-5578
Phone (016) 358-9420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20240620002259 MS Practitioner - General Surgery 4183991656 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Community Hospital PhysiciansGroup PAC ID 5193970523, 3 clinicians

Practice addresses (Care Compare)

146 Highland Pkwy
Suite C
Picayune, MS 39466-5576
Phone (601) 358-9765

Hospital & facility affiliations

  • Highland Community Hospital Hospital, Picayune, MS, CCN 250117
  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy12
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux12
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Community Hospital Physicians CurrentSince Jul 1, 2024 Accepting new patients
Forrest County General Hospital CurrentSince Jul 1, 2024 Accepting new patients
Forest General Dba Highland Community Hospital CurrentSince Jul 1, 2024 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Forrest County General Hospital Past Accepting new patients

Locations

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

128 Highland Pkwy
Ste 201
Picayune, MS 39466

130 Highland Pkwy
Picayune, MS 39466
Phone (601) 358-9400

146 Highland Pkwy
Ste C
Picayune, MS 39466
Phone (601) 358-9765

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1114450616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 HIGHLAND PKWY STE 201",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394665578",
            "telephone_number": "016-358-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR.",
            "address_2": "UNIVERSITY HEALTH SYSTEM PROFESSIONAL STAFF SERVICES",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-567-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "QI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "32678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.