NPIMap

Individual provider Active NPI

Andrew Yampolsky, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Philadelphia, PA
National Provider Identifier
1053620815
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
MD459099 Issued in PA
Practice address
909 Walnut Street
Suite 300
Philadelphia, PA 19107-5211
Phone
(215) 955-6215
Fax
(215) 923-9189
NPI assigned
Sep 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS040756 PA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X MD459099 PA Primary

Addresses

Primary practice location

909 Walnut Street
Suite 300
Philadelphia, PA 19107-5211

Mailing address

909 Walnut Street
Suite 300
Philadelphia, PA 19107-5211
Phone (215) 955-6215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160919000445 PA Practitioner - Oral Surgery 7416268826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
New York University College of Dentistry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-4000

1101 Market St
FL 19
Philadelphia, PA 19107-2926

111 S 11TH St
Philadelphia, PA 19107-4824

834 Walnut St
Suite 110
Philadelphia, PA 19107-5109
Phone (215) 503-4779

909 Walnut St
2ND Floor
Philadelphia, PA 19107-5211
Phone (215) 955-7000

925 Chestnut St
Philadelphia, PA 19107-4204

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision17
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DS040756PAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Jul 19, 2016 Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

950 E Haverford Rd
Ste 307
Bryn Mawr, PA 19010
Phone (610) 519-9125

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

10800 Knights Rd
Ste 125
Philadelphia, PA 19114
Phone (215) 904-1898

1100 Walnut St
Ste 603
Philadelphia, PA 19107
Phone (215) 922-2455

909 Walnut St
Ste 300
Philadelphia, PA 19107
Phone (215) 955-6215

Organizations & group practices 3

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 8

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": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1053620815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 WALNUT STREET",
            "address_2": "SUITE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075211",
            "telephone_number": "215-955-6215",
            "fax_number": "215-923-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 WALNUT STREET",
            "address_2": "SUITE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075211",
            "telephone_number": "215-955-6215",
            "fax_number": "215-923-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMPOLSKY",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-28",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS040756",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "MD459099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.