Individual provider Active NPI

Samuel D. Yang, MD

  • Internal Medicine Physician
  • Marysville, OH
National Provider Identifier
1851787410
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.129912 Issued in OH
Practice address
140 Colemans Xing Ste 210
Marysville, OH 43040-7080
Phone
(937) 644-1441
Fax
(937) 642-7760
NPI assigned
Apr 10, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.129912 OH
Internal Medicine Physician 207R00000X 35.129912 OH Primary

Addresses

Primary practice location

140 Colemans Xing Ste 210
Marysville, OH 43040-7080

Mailing address

140 Colemans Xing Ste 210
Marysville, OH 43040-7080
Phone (937) 644-1441

Other identifiers 1

IdentifierTypeStateIssuer
0348945MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190724002954 OH Practitioner - Hospitalist 4385951698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

140 Colemans Xing
Suite 210
Marysville, OH 43040-7080
Phone (937) 644-1441

Hospital & facility affiliations

  • Memorial Hospital Hospital, Marysville, OH, CCN 360092

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.129912OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Jul 19, 2021 Accepting new patients
Central Ohio Primary Care Physicians, Inc. Internal Medicine CurrentSince Jul 19, 2021 Accepting new patients
Central Ohio Primary Care Physicians Inc Hospitalist Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Memorial Hospital of Union County Past Accepting new patients

Locations

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

140 Colemans Crossing Blvd
Ste 210
Marysville, OH 43040
Phone (937) 644-1441

140 Colemans Crossing Blvd
Ste 110
Marysville, OH 43040
Phone (937) 578-7950

Interoperability endpoints

  • Direct secure messaging: syang18953@copcp.medicity.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1851787410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 COLEMANS XING STE 210",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430407080",
            "telephone_number": "937-644-1441",
            "fax_number": "937-642-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 COLEMANS XING STE 210",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430407080",
            "telephone_number": "937-644-1441",
            "fax_number": "937-642-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "SAMUEL",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-10",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.129912",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.129912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0348945",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

Verify at the official NPI Registry.