Michael Yan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

28762 Issued in NE

Practice address

2480 Llewellyn Ave Ste 5800
Fort Meade, MD 20755-5129

Phone

(301) 677-8798

NPI assigned

Mar 11, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1952727349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE STE 5800",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207555129",
            "telephone_number": "301-677-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE STE 5800",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207555129",
            "telephone_number": "301-677-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-11",
        "last_updated": "2024-07-03",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "28762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Woodfield, PHARMD
• Melissa Nycole Work, AU.D., MSEH
• Deborah Wright
• Marc F Wuerdeman, M.D.
• Keith A. Wunsch, D.D.S.
• Michael Elsworth Yapp, PHARM.D.
• Patricia Esther Youle-Schoedel, MSW
• David Yun, MD
• Melanie Bostic Zelaya, R.D.H.
• David Allen Zeller Jr., MPAS PA-C, APA, CCHP

• Pediatrics Physician in Fort Meade, MD
• Providers in Fort Meade, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.