Individual provider Active NPI

Sida Yan, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1447678958
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R0815 Issued in TX
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

Updated by the provider on May 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160525000059 TX Order and Referring Only - Family PracticePractitioner - Family Practice 8820387244

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0815TXMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: sida.yan@1068141690617860.direct.elationemr.com
  • Direct secure messaging: 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

Verify at the official NPI Registry.