Individual provider Active NPI

Maria C Yager, D.O.

  • Family Medicine Physician
  • Clarks Summit, PA
National Provider Identifier
1083752950
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS009297L Issued in PA
Practice address
1451 Hillside Dr
Clarks Summit, PA 18411-9504
Phone
(570) 586-2011
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS009297L PA Primary

Addresses

Primary practice location

1451 Hillside Dr
Clarks Summit, PA 18411-9504

Mailing address

1451 Hillside Dr
Clarks Summit, PA 18411-9504
Phone (570) 586-2011

Other identifiers 1

IdentifierTypeStateIssuer
1003085180065MedicaidPA

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
I20050519000115 PA Practitioner - Family Practice 7113968215 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Department of Human Services CurrentSince Jun 8, 1998 Accepting new patients
Pennsylvania Department of Public Welfare CurrentSince Jun 8, 1998 Accepting new patients

Locations

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pennsylvania Department of Human ServicesClarks Summit, PA, CCN 394012 Hospital W-2 Managing Employee
Operational/Managerial Control
Jul 29, 2019
Jul 31, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083752950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 HILLSIDE DR",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184119504",
            "telephone_number": "570-586-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 HILLSIDE DR",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184119504",
            "telephone_number": "570-586-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGER",
        "first_name": "MARIA",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS009297L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003085180065",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

Verify at the official NPI Registry.