Individual provider Active NPI

Jin-a Yi, AG-ACNP-BC

  • Acute Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1275245037
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
285242 Issued in AZ
Practice address
3131 E Clarendon Ave Ste 102
Phoenix, AZ 85016-7069
Phone
(602) 253-9168
NPI assigned
Dec 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 285242 AZ Primary

Addresses

Primary practice location

3131 E Clarendon Ave Ste 102
Phoenix, AZ 85016-7069

Mailing address

9623 W Monte Lindo
Peoria, AZ 85383-4340
Phone (602) 334-0362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230323001423 AZ Practitioner - Nurse Practitioner 4587038039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Cardiac Surgery PCGroup PAC ID 8426943036, 11 clinicians

Practice addresses (Care Compare)

3131 E Clarendon Ave
Suite 102
Phoenix, AZ 85016-7069
Phone (602) 253-9168

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285242AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Cardiac Surgery CurrentSince Mar 27, 2023 Accepting new patients
Phoenix Cardiac Surgery PC CurrentSince Mar 27, 2023 Accepting new patients

Locations

3131 E Clarendon Ave
Ste 102
Phoenix, AZ 85016
Phone (602) 253-9168

Organizations & group practices 2

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": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1275245037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9623 W MONTE LINDO",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853834340",
            "telephone_number": "602-334-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 E CLARENDON AVE STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167069",
            "telephone_number": "602-253-9168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "JIN-A",
        "credential": "AG-ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "285242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.