Yan Shi, M.D.

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

35.140369 Issued in OH

Practice address

11100 Euclid Ave
Cleveland, OH 44106-1716

Phone

(168) 443-0152

NPI assigned

Oct 30, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX, AZ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: yshi63171@prddirect.texaschildrens.org
• Direct secure messaging: yshi191131@direct.metrohealth.org

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.

• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427

  Family Medicine

  Medicare reassignment NPD
• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment NPD
• The Metrohealth System

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  NPD
• Banner-University Medical Group

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1639842677
  NPD
• Banner-University Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1922820935
  NPD
• Baylor College of Medicine

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1104867175
  NPD (past)
• Texas Children'S Hospital

  • Children's Hospital
  • Houston, TX
  • NPI 1477643690
  NPD (past)

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

{
    "created_epoch": "1319932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1194001503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "address_2": "SUITE 404D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "168-443-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "YAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-30",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "OH",
            "license": "35.140369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAL BOARD",
            "identifier": "35.140369",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD PHYSICIAN IN TRAINING",
            "identifier": "557792",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD PHYSICIAN IN TRAINING PERMIT",
            "identifier": "BP10039781",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shashirekha Shetty, PHD
• Michael Sheu, MD
• Katherine Shevchuk
• Tiffany Tien-Xin Shi, MD, PHD
• Wenxuan Shi
• Lisa Shiban, LISW
• Linda-Dalal J Shiber, MD
• Suha Shidiac, APRN
• Laila Shiekh Sroujieh, M.D
• Calvin L Shields

• Pediatric Surgery Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Pediatric Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.