Jackie Lai Yip, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA15631 Issued in CA

Practice address

11986 Pericles Dr
Rancho Cordova, CA 95742-8078

Phone

(916) 226-6228

NPI assigned

Jan 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Jackie Lai Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Centers of AmericaGroup PAC ID 3476813460, 112 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19797/brand/1/csg/1/fhir/r4

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.

• Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • Mariposa, CA
  • NPI 1891207684
  Medicare reassignment Care Compare group
• Chandan DS Cheema MD Inc

  dba Capital Medical Extended Care

  • Internal Medicine Physician
  • Fair Oaks, CA
  • NPI 1598965667
  Medicare reassignment
• SNF Wound Care

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1114393311
  Medicare reassignment
• Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • Gustine, CA
  • NPI 1245105733
  NPD
• Capital Medical Extended Care

  • Skilled Nursing Facility
  • Sacramento, CA
  • NPI 1295131092
  NPD (past)
• Central Stockton Medical Clinic

  • Family Medicine Physician
  • Stockton, CA
  • NPI 1932148343
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1710958814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11230 GOLD EXPRESS DR",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704484",
            "telephone_number": "916-214-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11986 PERICLES DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957428078",
            "telephone_number": "916-226-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIP",
        "first_name": "JACKIE",
        "middle_name": "LAI",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-28",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA15631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "LAI",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• CHI Nou Yang
• Joe Yang, MSW
• Rebecca Yeghiazaryan
• Yellow Wood Recovery Inc
• Yellow Wood Recovery Inc
• Ivette Marie Yoder, PHARM.D.
• Beverly Susan Young, CAS
• Your Choice Home Health Care, Inc.
• Edward Yuan, PHARM.D.
• Manaal Yunus

• Medical Physician Assistant in Rancho Cordova, CA
• Providers in Rancho Cordova, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.