Individual provider Active NPI

Gan Xin Yan, MD

  • Clinical Cardiac Electrophysiology Physician
  • Wynnewood, PA
National Provider Identifier
1467457150
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
MD070312L Issued in PA
Practice address
100 E Lancaster Ave
JD Lankenau Pavilion, Mezzanine
Wynnewood, PA 19096-3450
Phone
(484) 476-1000
Fax
(484) 476-9000
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X MD070312L PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
JD Lankenau Pavilion, Mezzanine
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
JD Lankenau Pavilion, Mezzanine
Wynnewood, PA 19096-3450
Phone (484) 476-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040303000158 PA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 6406743574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450

1020 Baltimore Pike
Suite 100
Glen Mills, PA 19342-1013
Phone (484) 227-7790

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (610) 566-9400

1088 W Baltimore Pike
Media, PA 19063-5166

1991 Sproul Rd
Broomall, PA 19008-3518

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

930 Germantown Pike
Plymouth Meeting, PA 19462-7400
Phone (484) 476-1000

Hospital & facility affiliations

  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD070312LPAMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Oct 13, 2008 Accepting new patients
Cardiovascular Associates of Southeaster Pennsylvania PC Past Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3855 West Chester Pike
Ste 250
Newtown Square, PA 19073
Phone (610) 527-1165

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

100 E Lancaster Ave
Rm 2202
Wynnewood, PA 19096
Phone (610) 645-2684

100 E Lancaster Ave
Ste 356
Wynnewood, PA 19096
Phone (484) 476-2684

100 E Lancaster Ave
Ste 556
Wynnewood, PA 19096
Phone (610) 649-6980

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1467457150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "JD LANKENAU PAVILION, MEZZANINE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-1000",
            "fax_number": "484-476-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "JD LANKENAU PAVILION, MEZZANINE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-1000",
            "fax_number": "484-476-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "GAN XIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "PA",
            "license": "MD070312L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.