Organization Active NPI

Dianna Yan MD PC

  • Specialist
  • Gaithersburg, MD
National Provider Identifier
1558599498
Registry record updated Jul 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D43385 Issued in MD
Legal business name
DIANNA YAN MD PC
Practice address
8909 Shady Grove CT
Gaithersburg, MD 20877-1308
Phone
(301) 963-0900
Fax
(301) 963-9694
NPI assigned
Jun 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2009

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

Authorized official

Name
Dianna Yan, M.D.NPI 1710928411
Title
Owner
Phone
(301) 963-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D43385 MD Primary

Addresses

Primary practice location

8909 Shady Grove CT
Gaithersburg, MD 20877-1308

Mailing address

8909 Shady Grove CT
Gaithersburg, MD 20877-1308
Phone (301) 963-0900

Other identifiers 2

IdentifierTypeStateIssuer
755631400MedicaidMD
133049OtherMDMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090804000011 DC Part B Supplier - Clinic/Group Practice 7315090065 Receives reassigned benefits from 1 practitioner
Practice locations: Gaithersburg, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246924800000",
    "number": "1558599498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8909 SHADY GROVE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771308",
            "telephone_number": "301-963-0900",
            "fax_number": "301-963-9694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8909 SHADY GROVE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771308",
            "telephone_number": "301-963-0900",
            "fax_number": "301-963-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANNA YAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-07-07",
        "status": "A",
        "authorized_official_last_name": "YAN",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-963-0900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D43385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "755631400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "133049",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.