Individual provider Active NPI

Wenfei Yang

  • Psychiatric/Mental Health Nurse Practitioner
  • East Chicago, IN
National Provider Identifier
1912558495
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71009599A Issued in IN
Practice address
100 W Chicago Ave
East Chicago, IN 46312-3260
Phone
(219) 703-5361
NPI assigned
Sep 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28194715A IN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71009599A IN Primary

Addresses

Primary practice location

100 W Chicago Ave
East Chicago, IN 46312-3260

Mailing address

336 Justina St
Hinsdale, IL 60521-2417
Phone (219) 252-2953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20201208000790 IL Practitioner - Nurse Practitioner 4082048087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primecare Community Health, Inc.Group PAC ID 6204722077, 41 clinicians

Practice addresses (Care Compare)

5635 W Belmont Ave
Chicago, IL 60634-4384
Phone (773) 736-1830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28194715AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare Community Health, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Primecare Community Health, Inc. Current Accepting new patients
Primecare Community Health Inc CurrentSince Sep 1, 2020 Accepting new patients
Primecare Community Health Inc. Past Accepting new patients

Locations

2211 N Elston Ave
Ste 301
Chicago, IL 60614

5635 W Belmont Ave
Chicago, IL 60634
Phone (773) 736-1830

3924 W Fullerton Ave
Chicago, IL 60647
Phone (773) 276-2229

1431 N Western Ave
Ste 406
Chicago, IL 60622
Phone (312) 491-5495

Organizations & group practices 4

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": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1912558495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 JUSTINA ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212417",
            "telephone_number": "219-252-2953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CHICAGO AVE",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123260",
            "telephone_number": "219-703-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "WENFEI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28194715A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71009599A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Chicago, IN

Sources for this page

Verify at the official NPI Registry.