Yaya Kishiyama Su, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35915 Issued in AZ

Practice address

6501 E Greenway Pkwy
Suite 160
Scottsdale, AZ 85254-2065

Phone

(480) 948-9903

Fax

(480) 998-5887

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Yaya Kishiyama Ody Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Perimeter North Family Practice LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1295936318
  NPD (past)
• Perimeter Professional Services, LLC

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235543620
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1851403828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 E GREENWAY PKWY",
            "address_2": "SUITE 160",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852542065",
            "telephone_number": "480-948-9903",
            "fax_number": "480-998-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 E GREENWAY PKWY",
            "address_2": "SUITE 160",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852542065",
            "telephone_number": "480-948-9903",
            "fax_number": "480-998-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "YAYA",
        "middle_name": "KISHIYAMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "35915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "AZ0921700",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YAYA",
            "last_name": "ODY",
            "middle_name": "KISHIYAMA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ross Lewis Stutman, MD
• Trevor Ryan Stutz, PT, DPT
• Kimberly Corriene Styles
• Cortney Stys
• Leon L Su, M.D.
• Ana Gabriela Suarez-Venot, DO
• Luis Fernando Suarez
• Mariusz Suchodolski, PT, DPT
• Nicole Sudsbury, PHARMD
• Carlos Alberto Suescun Jr., MD

• Family Medicine Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.