Individual provider Active NPI

Cai Yuan, MD

  • Hematology & Oncology Physician
  • Newburgh, IN
National Provider Identifier
1215341516
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
01086913A Issued in IN
Practice address
4055 Gateway Blvd
Newburgh, IN 47630-7451
Phone
(812) 858-3051
Fax
(812) 858-3060
NPI assigned
Jun 13, 2014
Last updated
Jan 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 036152623 IL
Hematology (Internal Medicine) Physician 207RH0000X 036152623 IL
Hematology & Oncology Physician 207RH0003X 01086913A IN Primary
Medical Oncology Physician 207RX0202X 036152623 IL

Addresses

Primary practice location

4055 Gateway Blvd
Newburgh, IN 47630-7451

Mailing address

2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-6188

Other practice location 1

2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-6188

Other identifiers 2

IdentifierTypeStateIssuer
036152623MedicaidIL
1215341516MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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

Enrollment IDStateProvider typePAC IDDetails
I20200529001738 IL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 0749556918 Reassigns benefits to 1 organization
I20220121001401 IN Practitioner - Hematology/Oncology 0749556918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4055 Gateway Blvd
Newburgh, IN 47630-7451
Phone (812) 858-3051

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036152623ILMDHematology (Internal Medicine) Physician
01086913AINMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jun 1, 2020 Accepting new patients
RMH Pathologists, LTD Current Accepting new patients
Deaconess Specialty Physicians, Inc Current Accepting new patients
Deaconess Specialty Physicians, Inc Hematology & Oncology CurrentSince Jan 12, 2022 Accepting new patients
Deaconess Specialty Physicians Inc CurrentSince Jan 12, 2022 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4055 Gateway Blvd
Newburgh, IN 47630
Phone (812) 842-2210

Interoperability endpoints

  • Direct secure messaging: cyuan229321@direct.deaconess.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1215341516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N ROCKTON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033655",
            "telephone_number": "815-971-6188",
            "fax_number": "815-968-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476307451",
            "telephone_number": "812-858-3051",
            "fax_number": "812-858-3060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 N Rockton Ave",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611033655",
            "country_code": "US",
            "telephone_number": "815-971-6188",
            "fax_number": "815-968-9677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUAN",
        "first_name": "CAI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036152623",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "IL",
            "license": "036152623",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01086913A",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036152623",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036152623",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215341516",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.