Individual provider Active NPI

Yenna Chin, PA-C

  • Physician Assistant
  • Sedona, AZ
National Provider Identifier
1134626534
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9814 Issued in AZ
Practice address
2030 W State Route 89a Ste B4
Sedona, AZ 86336-5407
Phone
(928) 202-9187
NPI assigned
Apr 11, 2018
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA7901 MA
Physician Assistant 363A00000X 9814 AZ Primary

Addresses

Primary practice location

2030 W State Route 89a Ste B4
Sedona, AZ 86336-5407

Mailing address

2030 W State Route 89a Ste B4
Sedona, AZ 86336-5407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20251125004494 NM Practitioner - Physician Assistant 1557618998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

4588 Paradise Blvd NW
Albuquerque, NM 87114-4105
Phone (505) 998-1717

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9814AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tribe Wellness Group PLLC CurrentSince Sep 1, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Aug 30, 2025 Accepting new patients
Presbyterian Healthcare Services CurrentSince Aug 30, 2025 Accepting new patients
Canyonlands Community Health Care Past Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients
Canyonlands Community Health Care Past Accepting new patients
Canyonlands Community Health Care Past Accepting new patients

Locations

2030 W State Route 89A
Ste B4
Sedona, AZ 86336
Phone (928) 202-9187

4588 Paradise Blvd NW
Albuquerque, NM 87114
Phone (505) 923-2070

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: ychin270014@direct.phs.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1134626534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 W STATE ROUTE 89A STE B4",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 W STATE ROUTE 89A STE B4",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365407",
            "telephone_number": "928-202-9187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "YENNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7901",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedona, AZ

Sources for this page

Verify at the official NPI Registry.