Individual provider Active NPI

Quanjian Yan, PA

  • Physician Assistant
  • Beaumont, CA
National Provider Identifier
1144796335
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
839 N. Highland Springs Ave
Beaumont, CA 92223-5767
Phone
(951) 845-0313
NPI assigned
Oct 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 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 103052 MT
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

839 N. Highland Springs Ave
Beaumont, CA 92223-5767

Mailing address

839 N. Highland Springs Ave
Beaumont, CA 92223-5767
Phone (951) 845-0313

Other practice location 1

1101 26th St S
Great Falls, MT 59405-5161
Phone (406) 731-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190108002042 NY Practitioner - Physician Assistant 3870839103 Reassigns benefits to 2 organizations
I20220915002734 CA Practitioner - Physician Assistant 3870839103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

839 Highland Springs Ave
Beaumont, CA 92223-5767

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56407CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C CurrentSince Feb 26, 2024 Accepting new patients
Beaver Medical Group P C CurrentSince Feb 26, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Nov 16, 2018 Accepting new patients
Centers for Family Medicine GP Current Accepting new patients
Montefiore Medical Center CurrentSince Nov 16, 2018 Accepting new patients
Cassidy Medical Group Inc. Current Accepting new patients
North Medical PC Past Accepting new patients

Locations

7000 Boulder Ave
Ste 103
Highland, CA 92346
Phone (515) 441-6271

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

111 E 210th St
Bronx, NY 10467

Organizations & group practices 9

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": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1144796335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 N. HIGHLAND SPRINGS AVE",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922235767",
            "telephone_number": "951-845-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 N. HIGHLAND SPRINGS AVE",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922235767",
            "telephone_number": "951-845-0313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 26th St S",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594055161",
            "country_code": "US",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAN",
        "first_name": "QUANJIAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "103052",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, CA

Sources for this page

Verify at the official NPI Registry.