Individual provider Active NPI

Yankuba A Sanyang, NP

  • Gerontology Nurse Practitioner
  • Eagan, MN
National Provider Identifier
1275068074
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
5098 Issued in MN
Practice address
2000 Rahncliff CT Ste 400
Eagan, MN 55122-3470
Phone
(888) 290-1209
NPI assigned
Apr 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 5098 MN Primary

Addresses

Primary practice location

2000 Rahncliff CT Ste 400
Eagan, MN 55122-3470

Mailing address

2004 Ford Pkwy
Saint Paul, MN 55116-1931
Phone (888) 290-1209

Other practice location 1

1415 Lilac Dr N Ste 190
Golden Valley, MN 55422-4544
Phone (763) 267-8701

Other practice location 2

2004 Ford Pkwy
Saint Paul, MN 55116-1931
Phone (888) 290-1209

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address yankuba.sanyang.1@31254.direct.athenahealth.com Direct Herself Health MN PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20170726000535 MN Practitioner - Nurse Practitioner 4284904160 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Herself Health MN PCGroup PAC ID 6507234820, 31 clinicians

Practice addresses (Care Compare)

2004 Ford Pkwy
Saint Paul, MN 55116-1931
Phone (612) 256-8225

Hospital & facility affiliations

  • M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus CurrentSince Mar 1, 2024 Accepting new patients
Herself Health MN PC CurrentSince Aug 5, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Dec 7, 2024 Accepting new patients
Ilbnc, P.a. PastSince Jan 9, 2023 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

121 Washington Ave N
Fl 4
Minneapolis, MN 55401
Phone (404) 992-2702

2000 Rahncliff Ct
Ste 400
Saint Paul, MN 55122
Phone (888) 290-1209

1010 Dale St N
Saint Paul, MN 55117
Phone (612) 482-6610

2004 Ford Pkwy
Saint Paul, MN 55116
Phone (612) 256-8225

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

Interoperability endpoints

  • Direct secure messaging: yankuba.sanyang.1@31254.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/31254/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

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": "1493424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1275068074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161931",
            "telephone_number": "888-290-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 RAHNCLIFF CT STE 400",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223470",
            "telephone_number": "888-290-1209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Lilac Dr N Ste 190",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554224544",
            "country_code": "US",
            "telephone_number": "763-267-8701",
            "fax_number": "763-231-9602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2004 Ford Pkwy",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551161931",
            "country_code": "US",
            "telephone_number": "888-290-1209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANYANG",
        "first_name": "YANKUBA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-29",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "5098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "yankuba.sanyang.1@31254.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "Herself Health MN PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2004 Ford Pkwy",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551161931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.