Individual provider Active NPI

Jun Yan, MD

  • Internal Medicine Physician
  • Bellevue, WA
National Provider Identifier
1124778410
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.MD.61683068 Issued in WA
Practice address
1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone
(425) 635-6600
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD.MD.61683068 WA Primary

Addresses

Primary practice location

1035 116TH Ave NE
Bellevue, WA 98004-4604

Mailing address

22 S Greene St RM N3E09
Baltimore, MD 21201-1544
Phone (410) 328-6110

Other practice location 1

22 S Greene St Rm N3E09
Baltimore, MD 21201-1544
Phone (410) 328-6110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20250913000704 WA Practitioner - Internal Medicine 6709260177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at Houston, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1231 116TH Ave NE
Bellevue, WA 98004-3804

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.MD.61683068WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics LLC CurrentSince Sep 8, 2025 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients

Locations

1231 116th Ave NE
Ste 400
Bellevue, WA 98004
Phone (425) 289-3100

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

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.

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": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1124778410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST RM N3E09",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-635-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St Rm N3E09",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-6110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAN",
        "first_name": "JUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD.MD.61683068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.