Individual provider Active NPI

Miao Tian

  • Anatomic Pathology & Clinical Pathology Physician
  • Modesto, CA
National Provider Identifier
1982127452
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A166044 Issued in CA
Practice address
4301 Northstar Way
Modesto, CA 95356
Phone
(209) 577-1200
Fax
(209) 577-6517
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A166044 CA Primary

Addresses

Primary practice location

4301 Northstar Way
Modesto, CA 95356

Mailing address

4301 Northstar Way
Modesto, CA 95356
Phone (209) 577-1200

Other practice location 1

1100 N State St
Los Angeles, CA 90033-5000
Phone (323) 409-5126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220425001100 CA Practitioner - Pathology 2961899802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yosemite Pathology Medical Group IncGroup PAC ID 3072415751, 45 clinicians

Practice addresses (Care Compare)

4301 N Star Way
Suite a
Modesto, CA 95356-9262
Phone (209) 577-1200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.8 of 100Reported as individual
Quality
80.29
Improvement activities
0
Cost
75.48

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yosemite Pathology Medical Group, Inc Anatomic Pathology & Clinical Pathology CurrentSince Jun 14, 2022 Accepting new patients
Yosemite Pathology Medical Group, in Past Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

1700 Coffee Rd
Modesto, CA 95355
Phone (209) 526-4500

4301 N Star Way
Ste A
Modesto, CA 95356

4301 N Star Way
Modesto, CA 95356
Phone (915) 521-2290

1421 Oakdale Rd
Modesto, CA 95355
Phone (209) 572-0151

350 S Oak Ave
Oakdale, CA 95361
Phone (209) 847-3011

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1982127452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 NORTHSTAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95356",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 NORTHSTAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95356",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-6517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N State St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335000",
            "country_code": "US",
            "telephone_number": "323-409-5126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIAN",
        "first_name": "MIAO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A166044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.