Individual provider Active NPI

Jeffrey Paul Yanez, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1851360739
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
YJ055460 Issued in MI
Practice address
18610 Fenkell St
Detroit, MI 48223-2378
Phone
(313) 723-6000
Fax
(313) 424-4058
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X YJ055460 MI Primary

Addresses

Primary practice location

18610 Fenkell St
Detroit, MI 48223-2378

Mailing address

30 W Monroe St Ste 1200
Chicago, IL 60603-2420
Phone (312) 733-9730

Other practice location 1

44405 Woodward Ave
H-13
Pontiac, MI 48341-5023
Phone (248) 858-3931

Other practice location 2

1142 E 9 Mile Rd
Hazel Park, MI 48030-1901
Phone (248) 817-4742

Other practice location 3

26390 Gratiot Ave
Roseville, MI 48066-5106
Phone (586) 221-7020

Other practice location 4

462 N Telegraph Rd
Pontiac, MI 48341-1037
Phone (248) 234-7540

Other practice location 5

14507 Woodward Ave
Highland Park, MI 48203-2905
Phone (313) 723-6100

Other identifiers 1

IdentifierTypeStateIssuer
3071060MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
YJ055460MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osh Mi Physicians Group, PC CurrentSince Aug 12, 2019 Accepting new patients
Osh-Mi Physicians Group PC Internal Medicine CurrentSince Aug 12, 2019 Accepting new patients
Osh-Mi Physicians Group PC Internal Medicine Past Accepting new patients
SJMH Medical Practice-SMHC Internal Medicine Past Accepting new patients

Locations

30 W Monroe St
Ste 1200
Chicago, IL 60603
Phone (773) 609-1758

18610 Fenkell St
Detroit, MI 48223
Phone (313) 723-6000

1142 E 9 Mile Rd
Hazel Park, MI 48030
Phone (248) 414-5770

14507 Woodward Ave
Highland Park, MI 48203
Phone (313) 306-5496

462 N Telegraph Rd
Pontiac, MI 48341
Phone (248) 234-7540

26390 Gratiot Ave
Roseville, MI 48066
Phone (586) 221-7020

Interoperability endpoints

  • Direct secure messaging: jyanez14039@direct.hfhs.org

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1851360739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032420",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18610 FENKELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482232378",
            "telephone_number": "313-723-6000",
            "fax_number": "313-424-4058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44405 Woodward Ave",
            "address_2": "H-13",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483415023",
            "country_code": "US",
            "telephone_number": "248-858-3931",
            "fax_number": "248-858-6499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1142 E 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Hazel Park",
            "state": "MI",
            "postal_code": "480301901",
            "country_code": "US",
            "telephone_number": "248-817-4742",
            "fax_number": "248-518-8719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26390 Gratiot Ave",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MI",
            "postal_code": "480665106",
            "country_code": "US",
            "telephone_number": "586-221-7020",
            "fax_number": "586-580-7485",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "462 N Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483411037",
            "country_code": "US",
            "telephone_number": "248-234-7540",
            "fax_number": "248-581-8716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14507 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "MI",
            "postal_code": "482032905",
            "country_code": "US",
            "telephone_number": "313-723-6100",
            "fax_number": "313-751-8102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANEZ",
        "first_name": "JEFFREY",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "YJ055460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3071060",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.