Individual provider Active NPI

Qiong Yang, M.D.

  • Surgical Critical Care Physician
  • Camden, NJ
National Provider Identifier
1528263829
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
25MA11020500 Issued in NJ
Practice address
1600 Haddon Ave
Camden, NJ 08103-3101
Phone
(856) 668-8818
Fax
(856) 668-8490
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X MD439894 PA
Surgical Critical Care Physician 2086S0102X 25MA11020500 NJ Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 25MA11020500 NJ
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD439894 PA

Addresses

Primary practice location

1600 Haddon Ave
Camden, NJ 08103-3101

Mailing address

45 Foxcroft Way
Mount Laurel, NJ 08054-5733
Phone (215) 301-5781

Other practice location 1

1600 Haddon Ave
Camden, NJ 08103-3101
Phone (856) 668-8818

Other identifiers 2

IdentifierTypeStateIssuer
0293679MedicaidNJ
102498162MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, OH2 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
I20210525000045 NJ Practitioner - Critical Care (Intensivists) 4486778446 Reassigns benefits to 1 organization
I20240320001831 OH Practitioner - Cardiovascular Disease (Cardiology) 4486778446 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11020500NJMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Feb 21, 2024 Accepting new patients
Virtua Medical Group, PA CurrentSince Jun 1, 2021 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Jun 1, 2021 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

1600 Haddon Ave
Fl 3
Camden, NJ 08103
Phone (609) 988-6260

301 Lippincott Dr
Ste 120
Marlton, NJ 08053
Phone (856) 355-0333

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1528263829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 FOXCROFT WAY",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080545733",
            "telephone_number": "215-301-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HADDON AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033101",
            "telephone_number": "856-668-8818",
            "fax_number": "856-668-8490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Haddon Ave",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081033101",
            "country_code": "US",
            "telephone_number": "856-668-8818",
            "fax_number": "856-668-8490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "QIONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "MD439894",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NJ",
            "license": "25MA11020500",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "25MA11020500",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD439894",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0293679",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102498162",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.