Individual provider Active NPI

Jin Yuan, M.D.

  • Pulmonary Disease Physician
  • Brockton, MA
National Provider Identifier
1710368493
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
279274 Issued in MA
Practice address
110 Liberty St
Brockton, MA 02301
Phone
(508) 894-0400
Fax
(508) 941-6461
NPI assigned
Jun 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 263614 MA
Pulmonary Disease Physician 207RP1001X 279274 MA Primary

Addresses

Primary practice location

110 Liberty St
Brockton, MA 02301

Mailing address

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 894-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20190715002045 MA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 0648519355 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
263614MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Massachusetts Inc Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Sound Physicians of Massachusetts, Inc Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Steward Medical Group, Inc CurrentSince Jun 1, 2022 Accepting new patients
Steward Medical Group, Inc CurrentSince Jun 1, 2022 Accepting new patients
Sound Physicians of Massachusetts Inc Internal Medicine Current Accepting new patients
Coastal Medical Associates CurrentSince Jun 15, 2022 Accepting new patients
Lahey Clinic, Inc. Internal Medicine CurrentSince Jun 22, 2020 Accepting new patients
Signature Healthcare Medical Group Inc Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

1 Pearl St
Ste 1400
Brockton, MA 02301
Phone (508) 897-6030

110 Liberty St
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

9 Galen St
Ste 155
Watertown, MA 02472
Phone (857) 304-2444

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Interoperability endpoints

  • Direct secure messaging: jin.yuan@direct.signature.masshiway.net

Organizations & group practices 8

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 2

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1710368493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-894-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-894-0400",
            "fax_number": "508-941-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUAN",
        "first_name": "JIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "263614",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "279274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.