Pedro Yen, M.D.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

K1958 Issued in TX

Practice address

1900 Oates Dr
Suite 138
Mesquite, TX 75150-6862

Phone

(972) 270-7600

Fax

(972) 270-9968

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Vital Medical Services, PA

  • Clinic/Center
  • Mesquite, TX
  • NPI 1063596534
  Medicare reassignment NPD Authorized official
• Ronald N Skufca DO PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1558433250
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1720163751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4137 WALNUT GLEN PL",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752296271",
            "telephone_number": "214-366-3796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 OATES DR",
            "address_2": "SUITE 138",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506862",
            "telephone_number": "972-270-7600",
            "fax_number": "972-270-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEN",
        "first_name": "PEDRO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K1958",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "K1958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092097701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• XI Wave Clinic
• Yahweh Home Health Care Services Inc
• Josie A. Yanez, LMSW
• Samiya Yasin
• Nathan Yeh
• David Yin
• Daniel Yohannes
• Brandi York
• Young Horizon Dental
• Aja Shardai Young

• Clinic/Center in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.