Individual provider Active NPI

Maiyia Lor Yang, NP-C

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1891067005
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2279 Issued in MN
Practice address
895 7TH St E
Saint Paul, MN 55106-3871
Phone
(651) 602-7500
Fax
(651) 222-1305
NPI assigned
Feb 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0411075 MN
Family Nurse Practitioner 363LF0000X 2279 MN Primary

Addresses

Primary practice location

895 7TH St E
Saint Paul, MN 55106-3871

Mailing address

895 7TH St E
Saint Paul, MN 55106-3871
Phone (651) 602-7500

Other identifiers 1

IdentifierTypeStateIssuer
2279OtherMNMN BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20140717001985 MN Practitioner - Nurse Practitioner 5395961973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Side Community Health Services, Inc.Group PAC ID 2062306434, 51 clinicians

Practice addresses (Care Compare)

895 7TH St E
Saint Paul, MN 55106-3871
Phone (651) 602-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2279MNMDRegistered Dietitian
F0411075MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Side Community Health Services, Inc. CurrentSince Jul 13, 2023 Accepting new patients
West Side Community Health Services, Inc. Current Accepting new patients
West Side Community Health Services, Inc CurrentSince Jul 13, 2023 Accepting new patients
Phalen Family Pharmacy LTD PastSince Sep 17, 2023 Accepting new patients
Phalen Family Pharmacy LTD PastSince Oct 27, 2019 Accepting new patients

Locations

895 7th St E
Saint Paul, MN 55106
Phone (651) 793-2250

380 E Lafayette Frontage Rd
Ste 200
Saint Paul, MN 55107
Phone (651) 602-7552

153 Cesar Chavez St
West Saint Paul, MN 55107
Phone (651) 222-1816

Interoperability endpoints

  • Direct secure messaging: myang733262@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1891067005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 7TH ST E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551063871",
            "telephone_number": "651-602-7500",
            "fax_number": "651-222-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 7TH ST E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551063871",
            "telephone_number": "651-602-7500",
            "fax_number": "651-222-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "MAIYIA",
        "middle_name": "LOR",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-02",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "F0411075",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BOARD OF NURSING",
            "identifier": "2279",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.