Individual provider Active NPI

Donovan Lyle Yamada, MD

  • Diagnostic Radiology Physician
  • Knoxville, TN
National Provider Identifier
1174631410
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
41726 Issued in TN
Practice address
2001 Laurel Ave # N304
Knoxville, TN 37916-1810
Phone
(865) 595-4100
Fax
(865) 766-0133
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 41726 TN Primary

Addresses

Primary practice location

2001 Laurel Ave # N304
Knoxville, TN 37916-1810

Mailing address

2001 Laurel Ave # N304
Knoxville, TN 37916-1810
Phone (865) 595-4100

Other identifiers 5

IdentifierTypeStateIssuer
3828091MedicaidTN
3828090MedicaidTN
P000379147OtherTNRR MCARE-CI
5905474MedicaidAL
P000365256OtherTNRR MCARE-ADR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20070126000674 TN Practitioner - Diagnostic Radiology 0547261901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Radiology, PCGroup PAC ID 9234041559, 64 clinicians

Practice addresses (Care Compare)

2001 Laurel Ave
Knoxville, TN 37916-1810
Phone (865) 546-9484

Hospital & facility affiliations

  • Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173
  • Affiliate of Vitruvian Health Hospital, Cleveland, TN, CCN 440185
  • Morristown Hamblen Hospital Association Hospital, Morristown, TN, CCN 440030
  • Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125
  • Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110

Merit-based Incentive Payment System (MIPS)

Final score
79.28 of 100Reported as group
Quality
75.62
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41726TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Radiology, PC. Diagnostic Radiology CurrentSince May 1, 2008 Accepting new patients
Plaza Radiology, PLLC Diagnostic Radiology PastSince Jan 1, 2012 Accepting new patients
Radcare of Tennessee PC Diagnostic Radiology Past Accepting new patients
Associates in Diagnostic Radiology Inc Diagnostic Radiology Past Accepting new patients
Radiology Alliance PC Diagnostic Radiology Past Accepting new patients

Locations

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

4709 Papermill Dr
Ste 201
Knoxville, TN 37909

Dept 888302
Knoxville, TN 37995

Organizations & group practices 5

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 5

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1174631410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE # N304",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161810",
            "telephone_number": "865-595-4100",
            "fax_number": "865-766-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE # N304",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161810",
            "telephone_number": "865-595-4100",
            "fax_number": "865-766-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMADA",
        "first_name": "DONOVAN",
        "middle_name": "LYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "41726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3828091",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3828090",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCARE-CI",
            "identifier": "P000379147",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905474",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCARE-ADR",
            "identifier": "P000365256",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.