NPIMap

Individual provider Active NPI

Tiffany Jean Yan, PA-C

  • Physician Assistant
  • Alliance, NE
National Provider Identifier
1760723522
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2388 Issued in NE
Practice address
2101 Box Butte Ave
Alliance, NE 69301-4444
Phone
(308) 762-6660
NPI assigned
Mar 4, 2013
Last updated
Jul 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0005373 CO
Physician Assistant 363A00000X PA60325568 WA
Physician Assistant 363A00000X 2388 NE Primary

Addresses

Primary practice location

2101 Box Butte Ave
Alliance, NE 69301-4444

Mailing address

11880 Airport Way
Broomfield, CO 80021-2767
Phone (720) 432-4419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180626002492 CO Practitioner - Physician Assistant 0941427587
I20190827001874 NE Practitioner - Physician Assistant 0941427587 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Box Butte General HospitalGroup PAC ID 9638089584, shared by 7 NPIs, 60 clinicians
Gordon Memorial HospitalGroup PAC ID 3072403575, 13 clinicians

Practice addresses (Care Compare)

2091 Box Butte Ave
Alliance, NE 69301-4458
Phone (308) 762-7244

300 E 8TH St
Gordon, NE 69343-1123
Phone (308) 282-0401

807 N Ash St
Gordon, NE 69343-1132
Phone (308) 282-1442

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2388NEMDMental Health Counselor
PA0005373COMDPhysician Assistant
PA60325568WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gordon Memorial Hospital CurrentSince Apr 1, 2024 Accepting new patients
Gordon Memorial Hospital CurrentSince Apr 1, 2024 Accepting new patients
Box Butte General Hospital CurrentSince Aug 14, 2019 Accepting new patients
Chadron Community Hospital Corp. CurrentSince Aug 4, 2019 Accepting new patients
Harlan County Health System Physician Assistant CurrentSince Jun 1, 2024 Accepting new patients
Box Butte General Hospital CurrentSince Aug 14, 2019 Accepting new patients
Box Butte General Hospital CurrentSince Nov 1, 2025 Accepting new patients
Box Butte General Hospital Current Accepting new patients
Regional West Physicians Clinic Past Accepting new patients

Locations

2091 Box Butte Ave
Ste 700
Alliance, NE 69301
Phone (308) 762-7244

2101 Box Butte Ave
Alliance, NE 69301
Phone (308) 762-6660

2107 Box Butte Ave
Alliance, NE 69301
Phone (308) 762-2534

717 Brown St
Alma, NE 68920
Phone (308) 928-2151

825 Centennial Dr
Chadron, NE 69337
Phone (308) 432-4441

300 E 8th St
Gordon, NE 69343
Phone (308) 282-0401

807 N Ash St
Gordon, NE 69343
Phone (308) 282-0401

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/gordon-7f82821b
  • Direct secure messaging: tklosterman@bbgh.securechart.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1362355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1760723522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11880 AIRPORT WAY",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212767",
            "telephone_number": "720-432-4419",
            "fax_number": "308-646-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 BOX BUTTE AVE",
            "city": "ALLIANCE",
            "state": "NE",
            "postal_code": "693014444",
            "telephone_number": "308-762-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "TIFFANY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-04",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0005373",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60325568",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, NE

Sources for this page

Verify at the official NPI Registry.