Individual provider Active NPI

Annie Yang, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1831771104
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA59916 Issued in CA
Practice address
1700 E Cesar E Chavez Ave Ste 2200
Los Angeles, CA 90033-2476
Phone
(323) 264-7600
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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 PA59916 CA Primary

Addresses

Primary practice location

1700 E Cesar E Chavez Ave Ste 2200
Los Angeles, CA 90033-2476

Mailing address

246 Sharon Rd
Arcadia, CA 91007-8043

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
I20220301000803 CA Practitioner - Physician Assistant 2163816547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Southern California Keck School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kevin J Pelton MD IncGroup PAC ID 3375625486, 38 clinicians

Practice addresses (Care Compare)

12215 Telegraph Rd
Suite 112
Santa Fe Springs, CA 90670-3344
Phone (562) 548-2230

1700 E Cesar Chavez Ave
Suite 2200
Los Angeles, CA 90033-2476

1700 E Cesar E Chavez Ave
Suite 2200
Los Angeles, CA 90033-2476
Phone (323) 264-7600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59916CAMDPediatric Dentist
PA59916CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin J Pelton MD Inc CurrentSince Nov 20, 2021 Accepting new patients
Kevin J. Pelton MD, Inc. CurrentSince Nov 20, 2021 Accepting new patients
White Memorial Medical Center Past Accepting new patients
Kevin J. Pelton MD, Inc. Past Accepting new patients

Locations

1700 E Cesar E Chavez Ave
Ste 2200
Los Angeles, CA 90033
Phone (323) 264-7600

12215 Telegraph Rd
Ste 112
Santa Fe Springs, CA 90670
Phone (562) 548-2230

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1831771104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 SHARON RD",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910078043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE STE 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332476",
            "telephone_number": "323-264-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "ANNIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.