Individual provider Active NPI

Yangdong He

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1386907038
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A135621 Issued in CA
Practice address
5411 Duncaster PL
Rancho Cucamonga, CA 91739-2603
Phone
(734) 358-2738
NPI assigned
Jun 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A135621 CA Primary

Addresses

Primary practice location

5411 Duncaster PL
Rancho Cucamonga, CA 91739-2603

Mailing address

5411 Duncaster PL
Rancho Cucamonga, CA 91739-2603
Phone (734) 358-2738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150729009209 CA Practitioner - HospitalistPractitioner - Internal Medicine 1153635560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10399 Lemon Ave
Suite 102B
Rancho Cucamonga, CA 91737-3771
Phone (909) 493-1277

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
135621CAMDSchool Social Worker
A135621CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yangdong He Medical Corporation Internal Medicine CurrentSince May 15, 2018 Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients

Locations

10399 Lemon Ave
Ste 102B
Rch Cucamonga, CA 91737
Phone (909) 481-1002

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1386907038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 DUNCASTER PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392603",
            "telephone_number": "734-358-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 DUNCASTER PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392603",
            "telephone_number": "734-358-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HE",
        "first_name": "YANGDONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A135621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.