Active NPI
Paul T Yellin, MD
- Orthopaedic Surgery Physician
- Woodbury, MN
National Provider Identifier
1114996147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 24429
- Practice address
- 2090 Woodwinds Dr
Woodbury, MN 55125-2522 - Phone
- (651) 968-5801
- Fax
- (651) 968-5899
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 24429 | MN | Primary |
Addresses
Primary practice location
2090 Woodwinds Dr
Woodbury, MN 55125-2522
Mailing address
710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5042
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200023917 | Other | MN | RAILROAD MEDICARE |
| 861892500 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24429 | MN | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435795200000",
"number": "1114996147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 COMMERCE DR STE 200",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551254925",
"telephone_number": "651-968-5042",
"fax_number": "651-968-5904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2090 WOODWINDS DR",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551252522",
"telephone_number": "651-968-5801",
"fax_number": "651-968-5899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YELLIN",
"first_name": "PAUL",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2015-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MN",
"license": "24429",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "200023917",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "861892500",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.