Jackie Yang, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

6627 Issued in MN

Practice address

546 S Elm St
Waconia, MN 55387-1814

Phone

(651) 603-4565

NPI assigned

Aug 25, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Lights Health LLCGroup PAC ID 6305278797, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Minnesota Hospice LLC Hospice, Lakeville, MN, CCN 241582
• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
• Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

Merit-based Incentive Payment System (MIPS)

Final score

97.69 of 100Reported as group

Quality

91.97

Improvement activities

40

Cost

69.67

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Northern Lights Health LLC

  • Primary Care Nurse Practitioner
  • Waconia, MN
  • NPI 1316581440

  WI

  Medicare reassignment Care Compare group NPD
• Hometown Physician Services MD, S.C.

  • Family Medicine Physician
  • Woodville, WI
  • NPI 1558832055

  MN

  Medicare reassignment NPD
• Waterside Healthcare & Wellness, LLC

  • Family Nurse Practitioner
  • Waconia, MN
  • NPI 1780223743
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation
• Minnesota Hospice LLC

  • Community Based Hospice Care Agency
  • Lakeville, MN
  • NPI 1891066239
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1174980692
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1194113217
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1245615772
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • Mental Illness Community Based Residential Treatment Facility
  • St Louis Park, MN
  • NPI 1578717336

  Hospital

  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1649220724
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1942585286
  Care Compare affiliation

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1235506247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 S ELM ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871814",
            "telephone_number": "651-603-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 S ELM ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871814",
            "telephone_number": "651-603-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "JACKIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "6627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Woodland, PT, DPT
• Katherine Wrazidlo
• Gary Edwin Wyard, M.D.
• Katherine J Wyffels
• Suzanna Wymore
• Charlie Yanisch
• Robert Aaron Yost, M.D.
• Amanda Katherine Youngren, MS, LPCC
• Annika Zallek, OTR
• Kimberly K Zaun, HIS

• Nurse Practitioner in Waconia, MN
• Providers in Waconia, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.