NPIMap

Individual provider Active NPI

Adam William Yngelmo, PA-C

  • Physical Medicine & Rehabilitation Physician
  • Wilkes-Barre, PA
National Provider Identifier
1184135121
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MA060498 Issued in PA
Practice address
150 Mundy Street
Mac IV Building
Wilkes-Barre, PA 18702-6380
Phone
(570) 824-0930
Fax
(570) 824-7755
NPI assigned
Oct 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6916 AZ
Physical Medicine & Rehabilitation Physician 208100000X MA060498 PA Primary

Addresses

Primary practice location

150 Mundy Street
Mac IV Building
Wilkes-Barre, PA 18702-6380

Mailing address

5 Morgan Hwy Ste 4
Scranton, PA 18508-2641
Phone (570) 344-3788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190710000032 PA Practitioner - Physician Assistant 2567724420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300

1201 Oak St
Pittston, PA 18640-3798
Phone (570) 808-9800

1800 Mulberry St
Scranton, PA 18510-2369
Phone (570) 969-7355

25 Church St
Wilkes Barre, PA 18702-3507
Phone (570) 808-3181

Hospital & facility affiliations

  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Feb 18, 2024 Accepting new patients
Geisinger Clinic Physician Assistant CurrentSince Feb 18, 2024 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1201 Oak St
Pittston, PA 18640
Phone (570) 808-9800

Organizations & group practices 4

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 30

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1184135121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MORGAN HWY STE 4",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082641",
            "telephone_number": "570-344-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MUNDY STREET",
            "address_2": "MAC IV BUILDING",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "187026380",
            "telephone_number": "570-824-0930",
            "fax_number": "570-824-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YNGELMO",
        "first_name": "ADAM",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-17",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6916",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MA060498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes-Barre, PA

Sources for this page

Verify at the official NPI Registry.