ANTELOPE VALLEY NEPHROLOGY MEDICAL GROUP, INC.
NPI 1336172949
Specialist in Lancaster, CA
About Antelope Valley Nephrology Medical Group, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANTELOPE VALLEY NEPHROLOGY MEDICAL GROUP, INC. (NPI 1336172949) is a healthcare organization registered as a specialist in Lancaster, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through December 31, 2027 and lists Sung C Yang, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Antelope Valley Nephrology Medical Group, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Antelope Valley Nephrology Medical Group, Inc., which bills Medicare for the services they deliver. Of these, 3 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D0587928
Antelope Valley Nephrology Medical Group · Lancaster, CAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Antelope Valley Nephrology Medical Group, Inc.'s NPI number?
The NPI number for Antelope Valley Nephrology Medical Group, Inc. is 1336172949. It was assigned to this organization in the NPPES registry on July 8, 2006.
Where is Antelope Valley Nephrology Medical Group, Inc. located?
Antelope Valley Nephrology Medical Group, Inc. is located at 1759 W Avenue J # 101, Lancaster, CA 93534. The listed phone number is (661) 948-1388.
What is Antelope Valley Nephrology Medical Group, Inc.'s specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Antelope Valley Nephrology Medical Group, Inc. enrolled in Medicare?
Yes. Antelope Valley Nephrology Medical Group, Inc. is registered in the Medicare PECOS enrollment system.
When is Antelope Valley Nephrology Medical Group, Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Antelope Valley Nephrology Medical Group, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Antelope Valley Nephrology Medical Group, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nephrology (3) and Internal Medicine (2). Of these, 3 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Antelope Valley Nephrology Medical Group, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D0587928) is associated with this NPI, valid through December 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Antelope Valley Nephrology Medical Group, Inc. was last updated on February 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Antelope Valley Nephrology Medical Group, Inc. · NPI 1336172949
Specialist organization in Lancaster, California. Organization record, active in the CMS NPPES registry since July 8, 2006.
## Identity
- **NPI:** 1336172949 (Entity type: Organization)
- **Enumerated:** July 8, 2006
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Sung Yang, ADMINISTRATOR
## Practice location
- **Address:** 1759 W AVENUE J # 101, Lancaster, CA 93534-2703
- **Phone:** (661) 948-1388 · **Fax:** (661) 948-1223
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 5 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nephrology (3), Internal Medicine (2); 3 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 23, 2016
- **Other identifiers:** Medicaid GR0002830 (CA); Medicare PIN W6508 (CA); Medicare PIN ZZZ15456Z (CA); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1336172949) · Data from the CMS NPPES public registry.