Organization Active NPI

Yale Mitchell Kadesky a Professional Medical Corporation

  • Plastic Surgery Physician
  • Escondido, CA
National Provider Identifier
1003982737
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
YALE MITCHELL KADESKY A PROFESSIONAL MEDICAL CORPORATION
Practice address
1045 E Pennsylvania Ave
Escondido, CA 92025-4616
Phone
(760) 741-5466
Fax
(760) 741-5656
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Yale M Kadesky, MDNPI 1437343605
Title
President
Phone
(760) 741-5466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

1045 E Pennsylvania Ave
Escondido, CA 92025-4616

Mailing address

1637 E Valley Pkwy # 222
Escondido, CA 92027-2408
Phone (760) 741-5466

Other identifiers 1

IdentifierTypeStateIssuer
00C500020MedicaidCA

Other names 1

  • Medical Prof Corp Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110126000315 CA Part B Supplier - Clinic/Group Practice 3173702974 Receives reassigned benefits from 1 practitioner
Practice locations: Escondido, CA

National Provider Directory

National Provider Directory

Locations

1045 E Pennsylvania Ave
Escondido, CA 92025
Phone (760) 741-5466

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1003982737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 E VALLEY PKWY # 222",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920272408",
            "telephone_number": "760-741-5466",
            "fax_number": "760-741-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 E PENNSYLVANIA AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254616",
            "telephone_number": "760-741-5466",
            "fax_number": "760-741-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YALE MITCHELL KADESKY A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2025-09-02",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "KADESKY",
        "authorized_official_first_name": "YALE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-741-5466",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C500020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Prof Corp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.