Dr. Yan Medical PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

280188 Issued in NY

Legal business name

DR. YAN MEDICAL PLLC

Practice address

13630 Maple Ave
Suite 2-I
Flushing, NY 11355-3824

Phone

(646) 250-1085

NPI assigned

Sep 19, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Xiaorong YanNPI 1811125776

Title

Owner

Phone

(646) 250-1085

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Xiaorong Yan, MD

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1811125776

  NY

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507075200000",
    "number": "1306365564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13630 MAPLE AVE",
            "address_2": "SUITE 2-I",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113353865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13630 MAPLE AVE",
            "address_2": "SUITE 2-I",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553824",
            "telephone_number": "646-250-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. YAN MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-10-04",
        "status": "A",
        "authorized_official_last_name": "YAN",
        "authorized_official_first_name": "XIAORONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-250-1085",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "280188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.