Individual provider Active NPI

Reginald Woodrow Yeske

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1114037330
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BY8095538 Issued in CA
Practice address
1190 N Studebaker Rd Ste H
Long Beach, CA 90815-4968
Phone
(562) 597-9402
Fax
(562) 498-5802
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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 BY8095538 CA Primary

Addresses

Primary practice location

1190 N Studebaker Rd Ste H
Long Beach, CA 90815-4968

Mailing address

1190 N Studebaker Rd Ste H
Long Beach, CA 90815-4968
Phone (562) 597-9402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20101124000393 CA Practitioner - Family Practice 5890981260 Practice locations: Long Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1190 N Studebaker Rd Unt H
Long Beach, CA 90815-4968
Phone (562) 597-9402

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BY8095538CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Long Beach Memorial Medical Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
University of California Irvine Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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 3

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1114037330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 N STUDEBAKER RD STE H",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154968",
            "telephone_number": "562-597-9402",
            "fax_number": "562-498-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 N STUDEBAKER RD STE H",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154968",
            "telephone_number": "562-597-9402",
            "fax_number": "562-498-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YESKE",
        "first_name": "REGINALD",
        "middle_name": "WOODROW",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "BY8095538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.