Individual provider Active NPI

Timothy Nai Kon Yu, MD

  • Emergency Medicine Physician
  • Jackson, MI
National Provider Identifier
1669001129
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A193681 Issued in CA
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-4800
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A193681 CA Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

533 Waymarket Dr
Ann Arbor, MI 48103-6619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20241004002343 CA Practitioner - Emergency Medicine 6800327578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Saint Louis University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians Associates San Jose PCGroup PAC ID 8921344292, 131 clinicians

Practice addresses (Care Compare)

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A193681CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Associates Fremont PC Emergency Medicine CurrentSince Jul 26, 2024 Accepting new patients
Emergency Physicians Associates San Jose PC Emergency Medicine CurrentSince Jul 26, 2024 Accepting new patients

Locations

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

1442 S Winchester Blvd
San Jose, CA 95128
Phone (510) 791-3430

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

Interoperability endpoints

  • Direct secure messaging: tyu208617@santaclaravalley.direct-ci.net

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.

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1669001129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 WAYMARKET DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "TIMOTHY",
        "middle_name": "NAI KON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A193681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.