Individual provider Active NPI

Roberta Kuo-Ju Yang, M.D.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1740308972
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD435300 Issued in PA
Practice address
111 S 11TH St
Suite 2170
Philadelphia, PA 19107-4824
Phone
(314) 323-8256
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A108549 CA
Diagnostic Radiology Physician 2085R0202X 2003013853 MO
Diagnostic Radiology Physician 2085R0202X MT192254 PA
Diagnostic Radiology Physician 2085R0202X MD435300 PA Primary

Addresses

Primary practice location

111 S 11TH St
Suite 2170
Philadelphia, PA 19107-4824

Mailing address

30 N 3Rd St Apt 4a
Philadelphia, PA 19106-2135
Phone (314) 323-8256

Other practice location 1

1510 E Herndon Ave Ste 110
Fresno, CA 93720-3333
Phone (559) 450-6742

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091009000132 CA Practitioner - Diagnostic Radiology 2961548607 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Washington University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians

Practice addresses (Care Compare)

1510 E Herndon Ave
Suite 110
Fresno, CA 93720-3333
Phone (559) 450-6742

Hospital & facility affiliations

  • Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
88.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A108549CAMDDiagnostic Radiology Physician
2003013853MOMDDiagnostic Radiology Physician
MD435300PAMDDiagnostic Radiology Physician
MT192254PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Imaging Institute Medical Group Inc CurrentSince Aug 20, 2009 Accepting new patients
Diagnostic Radiological Imaging Diagnostic Radiology CurrentSince Mar 14, 2018 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Mar 14, 2018 Accepting new patients
Forefront Radiology Medical Group PC Diagnostic Radiology CurrentSince Oct 1, 2019 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology Current Accepting new patients
LQMG Medical Group Inc. Current Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Mar 14, 2018 Accepting new patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Mar 14, 2018 Accepting new patients
Saint Agnes Medical Foundation CurrentSince Apr 6, 2024 Accepting new patients
Saint Agnes Medical Center Past Accepting new patients
Advanced Medical Imaging Past Accepting new patients

Locations

18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444

8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100

801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099

16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

7202 N Millbrook Ave
Ste 206
Fresno, CA 93720
Phone (559) 450-2300

1867 E Fir Ave
Ste 101
Fresno, CA 93720
Phone (559) 325-5800

1303 E Herndon Ave
Fresno, CA 93720
Phone (559) 449-3000

6297 N Fresno St
Fresno, CA 93710
Phone (559) 447-4000

1867 E Fir Ave
Ste 104
Fresno, CA 93720
Phone (559) 325-5800

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

1827 E Fir Ave
Ste 101
Fresno, CA 93720
Phone (559) 297-9002

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

1510 E Herndon Ave
Ste 110
Fresno, CA 93720
Phone (559) 450-6742

6191 N Thesta St
Fresno, CA 93710
Phone (559) 435-7200

9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314

2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333

3320 N Los Coyotes Diagonal
Ste 120
Long Beach, CA 90808
Phone (562) 627-0903

3715 E South St
Long Beach, CA 90805
Phone (562) 602-0700

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

27168 Newport Rd
Ste B
Menifee, CA 92584
Phone (951) 566-5725

8283 Grove Ave
Ste 101
Rch Cucamonga, CA 91730
Phone (909) 982-8638

79 Scripps Dr
Ste 100
Sacramento, CA 95825
Phone (916) 921-1200

300 Lombard St
Thousand Oaks, CA 91360
Phone (805) 495-1220

4516 Market St
Ventura, CA 93003
Phone (805) 654-8170

Interoperability endpoints

  • Direct secure messaging: ryang2712460@direct.trinity-health.org
  • FHIR API: https://api.platform.athenahealth.com/18604/brand/1/csg/1/fhir/r4

Organizations & group practices 11

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1740308972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 3RD ST APT 4A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191062135",
            "telephone_number": "314-323-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 2170",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "314-323-8256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 E Herndon Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203333",
            "country_code": "US",
            "telephone_number": "559-450-6742",
            "fax_number": "559-450-6743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "ROBERTA",
        "middle_name": "KUO-JU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A108549",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2003013853",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT192254",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD435300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.