Individual provider Active NPI

Caroline Yao, M.D.

  • Plastic Surgery Physician
  • Pasadena, CA
National Provider Identifier
1790041697
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A120821 Issued in CA
Practice address
909 S Fair Oaks Avenue
Pasadena, CA 91105-2625
Phone
(626) 389-9300
Fax
(626) 389-9336
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 273643 MA
Plastic Surgery Physician 208200000X A120821 CA Primary

Addresses

Primary practice location

909 S Fair Oaks Avenue
Pasadena, CA 91105-2625

Mailing address

909 S Fair Oaks Avenue
Pasadena, CA 91105-2625
Phone (626) 389-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130807000585 CA Practitioner - Plastic and Reconstructive Surgery 3870735681 Reassigns benefits to 1 organization
I20180618001129 MA Practitioner - Plastic and Reconstructive Surgery 3870735681

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
273643MAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Feb 22, 2020 Accepting new patients
Shriners Hospitals for Children CurrentSince Feb 22, 2020 Accepting new patients

Locations

909 S Fair Oaks Ave
Pasadena, CA 91105
Phone (213) 388-3151

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1790041697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 S FAIR OAKS AVENUE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052625",
            "telephone_number": "626-389-9300",
            "fax_number": "626-389-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 S FAIR OAKS AVENUE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052625",
            "telephone_number": "626-389-9300",
            "fax_number": "626-389-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAO",
        "first_name": "CAROLINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MA",
            "license": "273643",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A120821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.