Individual provider Active NPI

Mikar Yang

  • Family Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1205592425
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10712-33 Issued in WI
Practice address
1408 S 24TH St Unit 1
Milwaukee, WI 53204-2503
Phone
(414) 316-8692
Fax
(414) 763-0238
NPI assigned
Nov 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10712-33 WI Primary

Addresses

Primary practice location

1408 S 24TH St Unit 1
Milwaukee, WI 53204-2503

Mailing address

1408 S 24TH St Unit 1
Milwaukee, WI 53204-2503
Phone (414) 316-8692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220527001812 WI Practitioner - Nurse Practitioner 7113305467 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10712WIMDPhysical Therapist
10712-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Community Health Centers, Inc CurrentSince Apr 17, 2025 Accepting new patients
Outreach Community Health Centers, Inc. CurrentSince Apr 17, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince May 1, 2022 Accepting new patients
Trilogy Behavioral Health Services CurrentSince Aug 1, 2023 Accepting new patients
Outreach Community Health Centers, Inc Past Accepting new patients
Outreach Community Health Centers, Inc. Past Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

220 W Capitol Dr
Glendale, WI 53212
Phone (414) 964-9018

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

7384 N 60th St
Milwaukee, WI 53223
Phone (414) 737-4774

4858 N Mother Daniels Way
Milwaukee, WI 53209
Phone (414) 249-4613

2741 W Fond du Lac Ave
Milwaukee, WI 53210
Phone (725) 543-2935

Organizations & group practices 6

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": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1205592425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 S 24TH ST UNIT 1",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042503",
            "telephone_number": "414-316-8692",
            "fax_number": "414-763-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 S 24TH ST UNIT 1",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042503",
            "telephone_number": "414-316-8692",
            "fax_number": "414-763-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "MIKAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10712-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.