Individual provider Active NPI

Yina Mo, PA-C

  • Medical Physician Assistant
  • Chevy Chase, MD
National Provider Identifier
1376095604
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0006290 Issued in MD
Practice address
5425 Wisconsin Ave Ste 702
Chevy Chase, MD 20815-3578
Phone
(301) 634-1411
Fax
(301) 634-1425
NPI assigned
Nov 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0006290 MD Primary

Addresses

Primary practice location

5425 Wisconsin Ave Ste 702
Chevy Chase, MD 20815-3578

Mailing address

5425 Wisconsin Ave Ste 702
Chevy Chase, MD 20815-3578
Phone (301) 634-1411

Other practice location 1

5454 Wisconsin Ave Ste 1665
Chevy Chase, MD 20815-6901
Phone (301) 220-8346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20170215002728 DC Practitioner - Physician Assistant 8426331505 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0006290MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Vein Disease PLLC CurrentSince Oct 1, 2025 Accepting new patients
USA Vein Clinics of Chantilly LLC PastSince Jan 22, 2025 Accepting new patients
Maryland and Virginia Phlebology PC PastSince Mar 30, 2025 Accepting new patients

Locations

5454 Wisconsin Ave
Ste 1665
Chevy Chase, MD 20815
Phone (301) 220-8346

Organizations & group practices 3

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": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1376095604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 WISCONSIN AVE STE 702",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153578",
            "telephone_number": "301-634-1411",
            "fax_number": "301-634-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 WISCONSIN AVE STE 702",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153578",
            "telephone_number": "301-634-1411",
            "fax_number": "301-634-1425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5454 Wisconsin Ave Ste 1665",
            "address_purpose": "LOCATION",
            "city": "Chevy Chase",
            "state": "MD",
            "postal_code": "208156901",
            "country_code": "US",
            "telephone_number": "301-220-8346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MO",
        "first_name": "YINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0006290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

Verify at the official NPI Registry.