Individual provider Active NPI

Jim Yao, M.D.

  • Nephrology Physician
  • Munster, IN
National Provider Identifier
1427028968
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
01061528A Issued in IN
Practice address
314 Ridge Rd
Munster, IN 46321-1528
Phone
(219) 789-1169
Fax
(219) 836-9364
NPI assigned
Jan 26, 2006
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 01061528A IN Primary

Addresses

Primary practice location

314 Ridge Rd
Munster, IN 46321-1528

Mailing address

210 S Desplaines St
Chicago, IL 60661-5500
Phone (312) 654-2700

Other practice location 1

3700 W 203rd St Ste 201
Olympia Fields, IL 60461-1182
Phone (708) 952-3040

Other identifiers 1

IdentifierTypeStateIssuer
036115173MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jyao284088@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20060126000388 IN Practitioner - NephrologyPractitioner - Internal Medicine 7012988975 Reassigns benefits to 1 organization
I20060410000315 IL Practitioner - NephrologyPractitioner - Internal Medicine 7012988975 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Nephrology SCGroup PAC ID 9133023963, 52 clinicians

Practice addresses (Care Compare)

314 Ridge Rd
Munster, IN 46321-1528
Phone (219) 836-9317

9730 S Western Ave
Suite 326
Evergreen Park, IL 60805-2746
Phone (708) 952-3040

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Nephrology, S.C. Nephrology CurrentSince Feb 1, 2006 Accepting new patients
Specialty Physicians of Illinois, LLC CurrentSince Nov 20, 2019 Accepting new patients
Specialty Physicians of Illinois, LLC CurrentSince Nov 20, 2019 Accepting new patients

Locations

4026 Paysphere Cir
Chicago, IL 60674

825 W 35th St
Chicago, IL 60609
Phone (773) 890-4330

35318 Eagle Way
Chicago, IL 60678

9730 S Western Ave
Ste 326
Evergreen Pk, IL 60805
Phone (708) 346-7340

3700 W 203rd St
Ste 202
Olympia Fields, IL 60461
Phone (708) 679-2120

3700 W 203rd St
Ste 201
Olympia Flds, IL 60461
Phone (708) 679-2880

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

314 Ridge Rd
Munster, IN 46321
Phone (219) 789-1169

Interoperability endpoints

  • Direct secure messaging: jyao64190@direct.franciscanalliance.org
  • Direct secure messaging: jyao284088@direct.myadvocateaurora.org
  • Direct secure messaging: jyao18555@direct.acumenmd.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1427028968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S DESPLAINES ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606615500",
            "telephone_number": "312-654-2700",
            "fax_number": "312-654-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 RIDGE RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211528",
            "telephone_number": "219-789-1169",
            "fax_number": "219-836-9364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 W 203rd St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "604611182",
            "country_code": "US",
            "telephone_number": "708-952-3040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAO",
        "first_name": "JIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "01061528A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036115173",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jyao284088@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "314 Ridge Rd",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463211528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "314 Ridge Rd",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463211528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.