Individual provider Active NPI

Tianyuan Yin Cornell, MD

  • Psychiatry Physician
  • Saint Louis, MO
National Provider Identifier
1942644349
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2017033339 Issued in MO
Practice address
11102 Lindbergh Business CT
Saint Louis, MO 63123-7810
Phone
(314) 206-3400
NPI assigned
Apr 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2017033339 MO Primary

Addresses

Primary practice location

11102 Lindbergh Business CT
Saint Louis, MO 63123-7810

Mailing address

3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101
Phone (314) 206-3700

Other names 1

  • Tianyuan Yin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20171128000735 MO Practitioner - Psychiatry 0042526204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Missouri, Columbia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BJC Behavioral HealthGroup PAC ID 1153225271, shared by 2 NPIs, 63 clinicians

Practice addresses (Care Compare)

1085 Maple St
Farmington, MO 63640-1955
Phone (573) 756-5353

3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101
Phone (314) 206-3700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BJC Behavioral Health CurrentSince Oct 25, 2021 Accepting new patients
BJC Behavioral Health CurrentSince Oct 25, 2021 Accepting new patients

Locations

1085 Maple St
Farmington, MO 63640
Phone (573) 756-5353

1430 Olive St
Ste 500
Saint Louis, MO 63103
Phone (314) 206-3724

11102 Lindbergh Ct
Saint Louis, MO 63123
Phone (314) 206-3400

3309 S Kingshighway Blvd
Saint Louis, MO 63139
Phone (314) 534-9350

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 2

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": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1942644349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391101",
            "telephone_number": "314-206-3700",
            "fax_number": "314-525-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11102 LINDBERGH BUSINESS CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237810",
            "telephone_number": "314-206-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "TIANYUAN",
        "middle_name": "YIN",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2017033339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIANYUAN",
            "last_name": "YIN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.