Individual provider Active NPI

Yancheng Luo, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Boys Town, NE
National Provider Identifier
1639520547
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
33333 Issued in NE
Practice address
14000 Hospital Rd
Boys Town, NE 68022
Phone
(617) 935-4521
NPI assigned
Jun 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 267859 MA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 33333 NE Primary

Addresses

Primary practice location

14000 Hospital Rd
Boys Town, NE 68022

Mailing address

14000 Hospital Rd
Boys Town, NE 68022
Phone (617) 935-4521

Other practice location 1

Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone (617) 786-2687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 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
I20210623000872 NE Practitioner - Pediatric Medicine 6507153590 Reassigns benefits to 1 organization
I20230118001390 IA Practitioner - NeurologyPractitioner - Pediatric Medicine 6507153590 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33333NEMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan's Boys' Home Pediatrics CurrentSince Jul 19, 2021 Accepting new patients
ENT Services PC Past Accepting new patients

Locations

320 McKenzie Ave
Ste 202
Council Bluffs, IA 51503
Phone (712) 256-5272

2534 Glenn Ave
Sioux City, IA 51106
Phone (712) 274-7822

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

555 N 30th St
Omaha, NE 68131
Phone (402) 280-8100

Organizations & group practices 2

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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1639520547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 HOSPITAL RD",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "68022",
            "telephone_number": "617-935-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 HOSPITAL RD",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "68022",
            "telephone_number": "617-935-4521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Massachusetts General Hospital",
            "address_2": "55 Fruit St.",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02114",
            "country_code": "US",
            "telephone_number": "617-786-2687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUO",
        "first_name": "YANCHENG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "267859",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NE",
            "license": "33333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boys Town, NE

Sources for this page

Verify at the official NPI Registry.