Individual provider Active NPI

Dianna Evelyn Yip, D.O.

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1558659060
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R4349 Issued in TX
Practice address
4900 Mueller Blvd
Austin, TX 78723-3051
Phone
(512) 324-0197
NPI assigned
Jul 18, 2011
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34 OH
Pediatric Hospice and Palliative Medicine Physician 2080H0002X 34-010201 OH
Pediatric Hospice and Palliative Medicine Physician 2080H0002X 34 OH
Pediatric Hospice and Palliative Medicine Physician 2080H0002X R4349 TX
Pediatrics Physician 208000000X R4349 TX Primary

Addresses

Primary practice location

4900 Mueller Blvd
Austin, TX 78723-3051

Mailing address

2112 Teakwood Dr
Austin, TX 78757-7751

Other practice location 1

8133 Mesa Dr Ste 104
Austin, TX 78759-8655
Phone (512) 655-9815

Other identifiers 3

IdentifierTypeStateIssuer
0068586MedicaidOH
377865601MedicaidTX
600394YKZJOtherMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TX2 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
I20120802000300 OH Practitioner - Pediatric MedicinePractitioner - Pain ManagementPractitioner - Hospice/Palliative Care 5395991657 Reassigns benefits to 1 organization
I20171013000528 TX Practitioner - Pediatric MedicinePractitioner - Hospice/Palliative Care 5395991657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Hospice/Palliative Care
Education
University of North Texas HSC, College of Osteopathic Med, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dell Childrens Medical GroupGroup PAC ID 8224092978, 117 clinicians

Practice addresses (Care Compare)

1301 Barbara Jordan Blvd
Austin, TX 78723-3078

4900 Mueller Blvd
Austin, TX 78723-3051
Phone (512) 324-0000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34OHMDInternal Medicine Physician
34-010201OHMDPediatric Hospice and Palliative Medicine Physician
R4349TXMDPediatric Hospice and Palliative Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children's Medical Group CurrentSince Oct 1, 2017 Accepting new patients
Dell Children's Medical Group Pediatrics CurrentSince Oct 1, 2017 Accepting new patients
University Hospitals Medical Group Inc Pediatrics CurrentSince Aug 1, 2012 Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

20800 Harvard Rd
Fl 2
Highland Hills, OH 44122
Phone (216) 358-2156

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

4900 Mueller Blvd
#2
Austin, TX 78723

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1558659060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 TEAKWOOD DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787577751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233051",
            "telephone_number": "512-324-0197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8133 Mesa Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787598655",
            "country_code": "US",
            "telephone_number": "512-655-9815",
            "fax_number": "231-259-4430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YIP",
        "first_name": "DIANNA",
        "middle_name": "EVELYN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34",
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "34-010201",
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "34",
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "R4349",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R4349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068586",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377865601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "600394YKZJ",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.