Individual provider Active NPI

Calvin Christian Yann, PA-C

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1619745551
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9118304 Issued in FL
Practice address
1222 S Orange Ave FL 4
Orlando, FL 32806-1215
Phone
(321) 841-6444
Fax
(321) 843-4712
NPI assigned
Dec 19, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA9118304 FL Primary

Addresses

Primary practice location

1222 S Orange Ave FL 4
Orlando, FL 32806-1215

Mailing address

2151 Portlight Dr Apt 103
Orlando, FL 32814-6933
Phone (352) 999-8422

Other practice location 1

250 E Colonial Dr Ste 200
Orlando, FL 32801-1231
Phone (407) 835-4103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404002386 FL Practitioner - Physician Assistant 5294173621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

22 W Underwood St
Orlando, FL 32806-1110
Phone (407) 648-3800

32 W Gore St
Orlando, FL 32806-1134

52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111

76 W Underwood St
Orlando, FL 32806-1110

86 W Underwood St
Orlando, FL 32806-1110
Phone (407) 896-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9118304FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2024 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1222 S Orange Ave
Fl 4
Orlando, FL 32806
Phone (321) 841-7700

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 1

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": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1619745551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 PORTLIGHT DR APT 103",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328146933",
            "telephone_number": "352-999-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE FL 4",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-6444",
            "fax_number": "321-843-4712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 E Colonial Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328011231",
            "country_code": "US",
            "telephone_number": "407-835-4103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANN",
        "first_name": "CALVIN",
        "middle_name": "CHRISTIAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-19",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9118304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.