Individual provider Active NPI

Jingduan Yang, M.D.

  • Psychiatry Physician
  • Bryn Mawr, PA
National Provider Identifier
1356566905
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD422505PA Issued in PA
Practice address
940 E Haverford Rd
Suite 201
Bryn Mawr, PA 19010-3845
Phone
(610) 520-1128
Fax
(610) 520-1331
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MA07644100 NJ
Psychiatry Physician 2084P0800X MD422505PA PA Primary

Addresses

Primary practice location

940 E Haverford Rd
Suite 201
Bryn Mawr, PA 19010-3845

Mailing address

801 Pacer CT
Cherry Hill, NJ 08002-3855
Phone (215) 219-8745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ, NY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20040109000168 PA Practitioner - Psychiatry 3779483557 Reassigns benefits to 1 organization
I20230525002338 NJ Practitioner - Psychiatry 3779483557 Reassigns benefits to 1 organization
I20240201004136 NY Practitioner - Psychiatry 3779483557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northern Medical Center, Inc.Group PAC ID 5597194928, 4 clinicians

Practice addresses (Care Compare)

14 Jason PL
Suite 201
Middletown, NY 10940-1909
Phone (845) 800-5118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA07644100NJMDPsychiatry Physician
MD422505PAPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tao Clinic of Acupuncture Psychiatry CurrentSince Feb 3, 2023 Accepting new patients
Northern Medical Center, Inc CurrentSince Dec 23, 2023 Accepting new patients
Tao Integrative Acupuncture Past Accepting new patients
Philadelphia School of Psychoanalysis Past Accepting new patients

Locations

999 Route 73 N
Ste 200
Marlton, NJ 08053
Phone (856) 802-6888

999 Route 73 N
Ste 200A
Marlton, NJ 08053
Phone (856) 802-6888

14 Jason Pl
Ste 201
Middletown, NY 10940
Phone (845) 513-6616

14 Jason Pl
Ste 202
Middletown, NY 10940
Phone (845) 410-2300

940 E Haverford Rd
Ste 201
Bryn Mawr, PA 19010
Phone (610) 520-1128

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCIJCD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1356566905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 PACER CT",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080023855",
            "telephone_number": "215-219-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E HAVERFORD RD",
            "address_2": "SUITE 201",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103845",
            "telephone_number": "610-520-1128",
            "fax_number": "610-520-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "JINGDUAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MA07644100",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD422505PA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.