Individual provider Active NPI

Samuel Hyun Yang

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1639722267
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
PENDING Issued in GA
Practice address
5671 Peachtree Dunwoody Rd Ste 610
Atlanta, GA 30342-5013
Phone
(404) 257-8600
NPI assigned
Jul 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X PENDING GA Primary

Addresses

Primary practice location

5671 Peachtree Dunwoody Rd Ste 610
Atlanta, GA 30342-5013

Mailing address

1610 Highland Oaks Way
Lawrenceville, GA 30043-7703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200115001600 GA Practitioner - Anesthesiology Assistant 3274968516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Emory University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Specialists in Anesthesia, P.C.Group PAC ID 9830170059, 112 clinicians

Practice addresses (Care Compare)

5665 Peachtree Dunwoody Rd
Atlanta, GA 30342-1764
Phone (404) 257-1415

Hospital & facility affiliations

  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
PENDINGGAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Specialists in Anesthesia, P.C. Anesthesiologist Assistant CurrentSince Dec 5, 2019 Accepting new patients

Locations

5665 Ptree Dunwoody Rd NE
Sandy Springs, GA 30342
Phone (678) 843-7001

5671 Peachtree Dunwoody Rd
Ste 610
Sandy Springs, GA 30342
Phone (404) 257-1415

5671 Ptree Dunwoody Rd NE
Ste 800
Sandy Springs, GA 30342
Phone (404) 257-1415

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.

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": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1639722267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 HIGHLAND OAKS WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD STE 610",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425013",
            "telephone_number": "404-257-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "SAMUEL",
        "middle_name": "HYUN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.