Individual provider Active NPI

Jisang Yu, MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1902591449
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29598 Issued in NV
Practice address
2704 N Tenaya Way
Las Vegas, NV 89128-0424
Phone
(702) 877-5199
NPI assigned
Apr 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 29598 NV Primary

Addresses

Primary practice location

2704 N Tenaya Way
Las Vegas, NV 89128-0424

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

Other practice location 1

1550 W Craig Rd Ste 220
North Las Vegas, NV 89032-0329
Phone (702) 616-5801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20230628002210 NV Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6507224292

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1902591449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N TENAYA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280424",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 W Craig Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "North Las Vegas",
            "state": "NV",
            "postal_code": "890320329",
            "country_code": "US",
            "telephone_number": "702-616-5801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YU",
        "first_name": "JISANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-10",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "29598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.