Active NPI
Sida Yan, MD
- Family Medicine Physician
- San Antonio, TX
National Provider Identifier
1447678958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R0815
- Practice address
- 5755 NW Loop 410 Ste 102
San Antonio, TX 78238-2502 - Phone
- (210) 963-8445
- Fax
- (210) 520-0149
- NPI assigned
- Apr 1, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R0815 | TX | Primary |
Addresses
Primary practice location
5755 NW Loop 410 Ste 102
San Antonio, TX 78238-2502
Mailing address
3206 Roan Way
San Antonio, TX 78259-2221
Phone (314) 601-2796
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160525000059 | TX | Order and Referring Only - Family Practice | 8820387244 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0815 | TX | MD | Family Medicine Physician |
Interoperability endpoints
- sida.yan@1068141690617860.direct.elationemr.com
- sida.yan@546238333255684.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557273600000",
"number": "1447678958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3206 ROAN WAY",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782592221",
"telephone_number": "314-601-2796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5755 NW LOOP 410 STE 102",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782382502",
"telephone_number": "210-963-8445",
"fax_number": "210-520-0149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAN",
"first_name": "SIDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-01",
"last_updated": "2019-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "R0815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.