YANG QU (PA) – Physician Assistant, NPI 1205457900

YANG QU (PA) is a healthcare provider. based in Olympia, Washington. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA61230421 (WA). The NPI Number for YANG QU (PA) is 1205457900

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
YANG QU (PA)
NPI
1205457900
Phone
(360) 459-1700
Address
424 LILLY RD NE
Enumeration Date
4 May 2020
Last Update Date
5 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3604591700
Graduation Year
2020 (6 years ago)
PAC ID
9436543378
Group Practice PAC ID
5991791790
Professional Enrollment ID
I20220218001411
Address ID
WA985065132OL424XXNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

4,282 PHYSICIAN ASSISTANT in WA

Provider Addresses for YANG QU (PA)

  • 424 LILLY RD NE

    OLYMPIA, WA 985065132

    Phone: (360) 459-1700

    Type: Mailing

  • 9040 JACKSON AVE

    TACOMA, WA 984310001

    Phone: (253) 968-1484

    Type: Mailing

  • 9040A JACKSON AVE

    JOINT BASE LEWIS MCCHORD, WA 984310001

    Phone: (973) 818-3493

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 48 Open Payments records for all available years, with a total value of $1,427.

Total Amount is formed as General ($1,427) + Research ($0) + Ownership ($0) = $1,427.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($554).

Total Amount

$1,427

General + Research + Ownership

Payments

48

Total payment records

General Amount

$1,427

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220218001411IPhysician AssistantWATBD
I20240417003604IPhysician AssistantNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98506)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991791790View full group profile
NameSpecialtyState
Nurse PractitionerWA
D E R M A T O L O G YWA
-WA
Physician AssistantOR
Micrographic Dermatologic Surgery (Mds), Dermatology, Micrographic Dermatologic Surgery (Mds)IL
Physician AssistantWA

Reviews

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Frequently asked questions

Can I cross-check YANG QU (PA) using NPI 1205457900?
NPI 1205457900 belongs to YANG QU (PA); compare other details if you need extra assurance.
Would YANG QU (PA) appear as active to a payer?
You can treat YANG QU (PA) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with YANG QU (PA)?
YANG QU (PA)'s record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with YANG QU (PA)?
Directory geography for YANG QU (PA) centers on Olympia, Washington.
When was this NPI issued?
Enumeration for YANG QU (PA) is noted as May 4, 2020 where the registry provides it.

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