Individual provider Active NPI

David Chae Man Yi, MD

  • Family Medicine Physician
  • Trophy Club, TX
National Provider Identifier
1700899044
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M0321 Issued in TX
Practice address
945 Trophy Club Dr
Trophy Club, TX 76262-5580
Phone
(817) 430-9111
Fax
(817) 430-8911
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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 M0321 TX Primary

Addresses

Primary practice location

945 Trophy Club Dr
Trophy Club, TX 76262-5580

Mailing address

945 Trophy Club Drive
Trophy Club, TX 76262-5580
Phone (817) 430-9111

Other identifiers 3

IdentifierTypeStateIssuer
176877202MedicaidTX
176877201MedicaidTX
176877203MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050207000640 TX Practitioner - Family Practice 1153372180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trophy Club Family Medicine PAGroup PAC ID 4688734056, 3 clinicians

Practice addresses (Care Compare)

945 Trophy Club Dr
Trophy Club, TX 76262-5580
Phone 8174309111105

Hospital & facility affiliations

  • Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trophy Club Family Medicine PA Family Medicine CurrentSince Aug 1, 2008 Accepting new patients
Physicians and Allied Health Professionals Group, PA Family Medicine Past Accepting new patients

Locations

301 Trophy Lake Dr
Unit 136
Trophy Club, TX 76262
Phone (817) 430-9111

945 Trophy Club Dr
Trophy Club, TX 76262
Phone (817) 430-9111

Interoperability endpoints

  • Direct secure messaging: dyi459656@direct.sw.org
  • Direct secure messaging: david.yi@tcfmp.eclinicaldirectplus.com

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1700899044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 TROPHY CLUB DRIVE",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625580",
            "telephone_number": "817-430-9111",
            "fax_number": "817-430-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 TROPHY CLUB DR",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625580",
            "telephone_number": "817-430-9111",
            "fax_number": "817-430-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "DAVID",
        "middle_name": "CHAE MAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M0321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176877202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176877201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176877203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trophy Club, TX

Sources for this page

Verify at the official NPI Registry.