Individual provider Active NPI

Robert G Yager Jr., DO

  • Psychiatry Physician
  • Duryea, PA
National Provider Identifier
1003915760
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS008295L Issued in PA
Practice address
123 Hillcrest Dr
Duryea, PA 18642-1532
Phone
(570) 647-2888
Fax
(570) 586-2714
NPI assigned
Sep 21, 2006
Last updated
Aug 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OS008295L PA Primary

Addresses

Primary practice location

123 Hillcrest Dr
Duryea, PA 18642-1532

Mailing address

123 Hillcrest Dr
Duryea, PA 18642-1532
Phone (570) 430-3310

Other identifiers 1

IdentifierTypeStateIssuer
1544268MedicaidPA

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
I20071031000075 PA Practitioner - Psychiatry 5395832885 Reassigns benefits to 1 organization
Practice locations: Moosic, PA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Philadelphia College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1451 Hillside Dr
Clarks Summit, PA 18411-9504
Phone (570) 857-7251

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS008295LPAMDPsychiatry Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1003915760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 HILLCREST DR",
            "city": "DURYEA",
            "state": "PA",
            "postal_code": "186421532",
            "telephone_number": "570-430-3310",
            "fax_number": "570-586-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HILLCREST DR",
            "city": "DURYEA",
            "state": "PA",
            "postal_code": "186421532",
            "telephone_number": "570-647-2888",
            "fax_number": "570-586-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGER",
        "first_name": "ROBERT",
        "middle_name": "G",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS008295L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1544268",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duryea, PA

Sources for this page

Verify at the official NPI Registry.