Individual provider Active NPI

Lyan Chang Sedano, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1962290023
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT234785 Issued in PA
Practice address
3401 N. Broad St. Temple University Hospital
Suite 810
Philadelphia, PA 19140
Phone
(215) 707-4085
Fax
(215) 707-5978
NPI assigned
Apr 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT234785 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3401 N. Broad St. Temple University Hospital
Suite 810
Philadelphia, PA 19140

Mailing address

3401 N. Broad St. Temple University Hospital
Suite 810
Philadelphia, PA 19140
Phone (215) 707-4085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251016004918 PA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9537656095

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": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1962290023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N. BROAD ST. TEMPLE UNIVERSITY HOSPITAL",
            "address_2": "SUITE 810",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "215-707-4085",
            "fax_number": "215-707-5978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N. BROAD ST. TEMPLE UNIVERSITY HOSPITAL",
            "address_2": "SUITE 810",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "215-707-4085",
            "fax_number": "215-707-5978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG SEDANO",
        "first_name": "LYAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT234785",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.