Individual provider Active NPI

Yuan Yuan Mirow, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1861506446
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD065962L Issued in PA
Practice address
801 Arch St
Suite 104
Philadelphia, PA 19107-2412
Phone
(215) 955-5279
Fax
(215) 923-5775
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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 MD065962L PA Primary

Addresses

Primary practice location

801 Arch St
Suite 104
Philadelphia, PA 19107-2412

Mailing address

801 Arch St
Suite 104
Philadelphia, PA 19107-2412
Phone (215) 955-5279

Other identifiers 1

IdentifierTypeStateIssuer
0017086000004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090219000664 PA Practitioner - Internal Medicine 0648335901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

110 N 8TH St
Suite 104
Philadelphia, PA 19107-5157
Phone (215) 955-5279

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD059905LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Methodist Associates in Healthcare, Inc Internal Medicine Current Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Apr 1, 2020 Accepting new patients

Locations

801 Arch St
Ste 104
Philadelphia, PA 19107
Phone (215) 955-1120

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

801 Arch St
#104
Philadelphia, PA 19107

Organizations & group practices 3

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1861506446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ARCH ST",
            "address_2": "SUITE 104",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191072412",
            "telephone_number": "215-955-5279",
            "fax_number": "215-923-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 ARCH ST",
            "address_2": "SUITE 104",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191072412",
            "telephone_number": "215-955-5279",
            "fax_number": "215-923-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIROW",
        "first_name": "YUAN",
        "middle_name": "YUAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD065962L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017086000004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.