Individual provider Active NPI

Daniel Adam Yanov

  • Physician Assistant
  • Concord, CA
National Provider Identifier
1144987504
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1006 Wild Oak CT
Concord, CA 94521-4530
Phone
(925) 207-0099
NPI assigned
Nov 19, 2021
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1006 Wild Oak CT
Concord, CA 94521-4530

Mailing address

1490 N Turquoise Dr
Flagstaff, AZ 86001-1383
Phone (928) 774-5074

Other practice location 1

450 S Willard St Ste 115
Cottonwood, AZ 86326-6744
Phone (928) 639-9596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220425002480 AZ Practitioner - Physician Assistant 1951798719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Dermatology Care PLLCGroup PAC ID 6709040256, 5 clinicians

Practice addresses (Care Compare)

11000 N Scottsdale Rd
Suite 120
Scottsdale, AZ 85254-6169
Phone (480) 596-1110

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.49 of 100Reported as individual
Quality
57.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8973AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Dermatology Center PC CurrentSince Mar 23, 2024 Accepting new patients
Northern Arizona Dermatology Center PC CurrentSince Mar 23, 2024 Accepting new patients
Northern Arizona Dermatology Center, PC Past Accepting new patients

Locations

297 S Willard St
Cottonwood, AZ 86326
Phone (928) 639-9596

450 S Willard St
Ste 115
Cottonwood, AZ 86326
Phone (928) 634-3025

1490 N Turquoise Dr
Flagstaff, AZ 86001
Phone (928) 744-5074

95 Soldiers Pass Rd
Ste C2
Sedona, AZ 86336
Phone (928) 282-2612

Interoperability endpoints

  • Direct secure messaging: dyanov@naznew.emadirect.md

Organizations & group practices 4

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.

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": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1144987504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 N TURQUOISE DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011383",
            "telephone_number": "928-774-5074",
            "fax_number": "928-779-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 WILD OAK CT",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945214530",
            "telephone_number": "925-207-0099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 S Willard St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863266744",
            "country_code": "US",
            "telephone_number": "928-639-9596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANOV",
        "first_name": "DANIEL",
        "middle_name": "ADAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-19",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.