Individual provider Active NPI

Sean Yeckley

  • Surgical Physician Assistant
  • Batavia, NY
National Provider Identifier
1003474198
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
026470 Issued in NY
Practice address
127 North St
Batavia, NY 14020-1631
Phone
(585) 344-5470
Fax
(585) 344-7451
NPI assigned
Jun 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA060685 PA
Surgical Physician Assistant 363AS0400X 026470 NY Primary

Addresses

Primary practice location

127 North St
Batavia, NY 14020-1631

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 344-5470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210608001438 NY Practitioner - Physician Assistant 7012241391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Memorial Medical CenterGroup PAC ID 0547259376, 271 clinicians

Practice addresses (Care Compare)

127 N St
Batavia, NY 14020-1631

16 Bank St
Batavia, NY 14020-2250
Phone (585) 344-4800

229 Summit St
Batavia, NY 14020-1645

Hospital & facility affiliations

  • United Memorial Medical Center Hospital, Batavia, NY, CCN 330073
  • Unity Hospital Hospital, Rochester, NY, CCN 330226

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
026470NYMDGeneral Practice Dentistry
MA060685PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orleans Community Health CurrentSince Feb 1, 2022 Accepting new patients
United Memorial Medical Center CurrentSince Jul 19, 2021 Accepting new patients
United Memorial Medical Center Past Accepting new patients

Locations

229 Summit St
Ste 1
Batavia, NY 14020
Phone (585) 343-4440

127 North St
Batavia, NY 14020
Phone (585) 267-7510

16 Bank St
Batavia, NY 14020
Phone (585) 344-4800

200 Ohio St
Medina, NY 14103
Phone (585) 798-2000

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Interoperability endpoints

  • Direct secure messaging: syeckley325356@direct.rochesterregional.org

Organizations & group practices 5

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 10

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": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1003474198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-344-5470",
            "fax_number": "585-344-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 NORTH ST",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140201631",
            "telephone_number": "585-344-5470",
            "fax_number": "585-344-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YECKLEY",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA060685",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "026470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, NY

Sources for this page

Verify at the official NPI Registry.