Active NPI
Yieshan Melissa Chan, M.D.
- Anesthesiology Physician
- Jackson, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301090983
- Practice address
- 2500 N State St
Jackson, MS 39216-4500 - Phone
- (601) 815-4775
- Fax
- (601) 984-6451
- NPI assigned
- Aug 10, 2007
- Last updated
- Jul 9, 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4301090983 | MI | Primary |
Addresses
Primary practice location
2500 N State St
Jackson, MS 39216-4500
Mailing address
2500 N State St
Jackson, MS 39216-4500
Phone (601) 851-5477
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04778891 | Medicaid | MS | |
| 2366653 | Medicaid | LA |
Other names 1
- Dr. Yie Shan Chan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Texas Tech University Health Science Center School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1225 N State St
Ms Baptist Medical Center
Jackson, MS 39202-2064
Phone (601) 317-2802
350 Crossgates Blvd
Brandon, MS 39042-2601
Phone (604) 317-2802
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301090983 | MI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current | Accepting new patients | |
| Perioperative Services of Mississippi, LLC | Anesthesiology | Current | Accepting new patients |
| Guardian Anesthesia Services, PC | Anesthesiology | Past | Accepting new patients |
Locations
350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500
2500 N State St
Jackson, MS 39216
Phone (601) 815-4775
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Jackson, MS
- NPI 1881123123
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1154317527
-
- Prosthetic/Orthotic Supplier
- Jackson, MS
- NPI 1235019530
-
- Anesthesiology Physician
- Tulsa, OK
- NPI 1205803095
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1710909585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404864000000",
"number": "1467644773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-851-5477",
"fax_number": "601-984-6451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-815-4775",
"fax_number": "601-984-6451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "YIESHAN",
"middle_name": "MELISSA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-10",
"last_updated": "2014-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301090983",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04778891",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2366653",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "YIE",
"last_name": "CHAN",
"middle_name": "SHAN",
"prefix": "DR.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.