Yannick Maxime Momo Tefo, DPT, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SC007589 Issued in PA

Practice address

5515 Peach St
Erie, PA 16509-2603

Phone

(814) 868-8217

NPI assigned

Jun 11, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1093383564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WILLIAMSBURG CIR",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600307904",
            "telephone_number": "563-676-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-868-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMO TEFO",
        "first_name": "YANNICK",
        "middle_name": "MAXIME",
        "name_prefix": "Dr.",
        "credential": "DPT, DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.024167",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC007589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Moldovan, DPT, PT
• Amber Carlisse Mole
• Mackenzie Molesworth, RN
• Kenneth G. Molinero Jr., DO
• Michael Robert Molitoris, MA, CCC-SLP
• Mason Anthony Monen, DO
• Mia Mong, PA-C
• Sabrina Lin Mong
• Virginia Kay Monroe, COTA
• Elena Montebell, SLP

• Podiatrist in Erie, PA
• Providers in Erie, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.