Individual provider Active NPI

Yanna Xiong, PA

  • Physician Assistant
  • Monterey Park, CA
National Provider Identifier
1730896788
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61818 Issued in CA
Practice address
850 S Atlantic Blvd Ste 101
Monterey Park, CA 91754-6700
Phone
(626) 284-1350
NPI assigned
Oct 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61818 CA Primary

Addresses

Primary practice location

850 S Atlantic Blvd Ste 101
Monterey Park, CA 91754-6700

Mailing address

850 S Atlantic Blvd Ste 101
Monterey Park, CA 91754-6700

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240524000521 CA Practitioner - Physician Assistant 5294177069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fernando Ibarra MD IncGroup PAC ID 3779664453, 3 clinicians

Practice addresses (Care Compare)

309 W Beverly Blvd
Montebello, CA 90640-4308
Phone (626) 284-1350

3400 E Florence Ave
Suite a
Huntington Park, CA 90255-5835
Phone (626) 284-1350

850 S Atlantic Blvd
Suite 101
Monterey Park, CA 91754-6700
Phone (626) 284-1350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61818CAMDDentist
PA61818CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Medical of Los Angeles Inc CurrentSince Nov 1, 2022 Accepting new patients

Locations

850 S Atlantic Blvd
Ste 101
Monterey Park, CA 91754
Phone (626) 281-6200

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.

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1730896788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S ATLANTIC BLVD STE 101",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917546700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S ATLANTIC BLVD STE 101",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917546700",
            "telephone_number": "626-284-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIONG",
        "first_name": "YANNA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.