Individual provider Active NPI

Chris Park Yang, M.D.

  • Pediatric Critical Care Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1588714463
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
55189 Issued in MN
Practice address
2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4289
Phone
(612) 813-3300
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 55189 MN Primary

Addresses

Primary practice location

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4289

Mailing address

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4289
Phone (612) 813-3300

Other identifiers 1

IdentifierTypeStateIssuer
416017700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20120716000511 MN Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 3476614082 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55189MNMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Children'S Specialty Healthcare CurrentSince Jan 9, 2018 Accepting new patients
Children'S Respiratory & Critical Care Specialists. P.a. CurrentSince Jul 1, 2012 Accepting new patients
Gillette Children'S Specialty Healthcare CurrentSince Jan 9, 2018 Accepting new patients
Johns Hopkins Emergency Medical Past Accepting new patients
Gillette Children'S Specialty Healthcare Past Accepting new patients
Childrens Health Care Past Accepting new patients

Locations

2530 Chicago Ave
Ste 400
Minneapolis, MN 55404
Phone (612) 813-3300

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

Organizations & group practices 6

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1588714463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-813-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-813-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "CHRIS",
        "middle_name": "PARK",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MN",
            "license": "55189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416017700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.