Individual provider Active NPI

Anda Karleen Balderrama Yangson, MD

  • Family Medicine Physician
  • La Grande, OR
National Provider Identifier
1629292404
Registry record updated Aug 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD28564 Issued in OR
Practice address
506 4TH St
La Grande, OR 97850-1906
Phone
(514) 663-3138
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD28564 OR Primary

Addresses

Primary practice location

506 4TH St
La Grande, OR 97850-1906

Mailing address

501 4TH St
La Grande, OR 97850-1905
Phone (541) 663-3138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20080904000353 OR Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Family Practice 1951477603 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

665 Winter St SE
Salem, OR 97301-3934
Phone (503) 561-5200

890 Oak St SE
Salem, OR 97301-3905
Phone (503) 561-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD28564ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health CurrentSince Jul 1, 2011 Accepting new patients
Salem Health Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
Salem Health West Valley CurrentSince Feb 1, 2018 Accepting new patients

Locations

525 SE Washington St
Dallas, OR 97338
Phone (503) 623-7344

1601 Monmouth St
Ste 100
Independence, OR 97351
Phone (503) 623-8301

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

875 Oak St SE
Salem, OR 97301
Phone (503) 561-5719

1049 Edgewater St NW
#150
Salem, OR 97304
Phone (503) 814-3343

Interoperability endpoints

  • Direct secure messaging: ayangson27686@direct.salemhealth.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250467200000",
    "number": "1629292404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 4TH ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501905",
            "telephone_number": "541-663-3138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 4TH ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501906",
            "telephone_number": "514-663-3138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANGSON",
        "first_name": "ANDA",
        "middle_name": "KARLEEN BALDERRAMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2009-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD28564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.