Individual provider Active NPI

Myron William Yencha Jr., MD

  • Otolaryngology Physician
  • Jacksonville, NC
National Provider Identifier
1184610446
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
201800981 Issued in NC
Practice address
55 Office Park Dr
Jacksonville, NC 28546-7327
Phone
(910) 219-3377
Fax
(910) 219-4227
NPI assigned
Sep 22, 2005
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0101046907 VA
Otolaryngology Physician 207Y00000X 201800981 NC Primary

Addresses

Primary practice location

55 Office Park Dr
Jacksonville, NC 28546-7327

Mailing address

55 Office Park Dr
Jacksonville, NC 28546-7327
Phone (910) 219-3377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20180925002851 NC Practitioner - OtolaryngologyPractitioner - Sleep Medicine 0749416378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Sleep Medicine
Education
Temple University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onslow Ambulatory Services IncGroup PAC ID 4587569256, 18 clinicians

Practice addresses (Care Compare)

55 Office Park Dr
Jacksonville, NC 28546-7327
Phone (910) 219-3377

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.53 of 100Reported as group
Quality
90.05
Promoting interoperability
100
Improvement activities
40
Cost
75.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201800981NCMDOtolaryngology Physician
0101046907VAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Onslow Ambulatory Services, Inc. CurrentSince Mar 27, 2022 Accepting new patients
Onslow Ambulatory Services, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Onslow Ambulatory Services, Inc. Otolaryngology CurrentSince Oct 1, 2018 Accepting new patients

Locations

215B Station St
Jacksonville, NC 28546
Phone (910) 455-8669

55 Office Park Dr
Jacksonville, NC 28546
Phone (910) 219-3377

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1184610446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 OFFICE PARK DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467327",
            "telephone_number": "910-219-3377",
            "fax_number": "910-219-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 OFFICE PARK DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467327",
            "telephone_number": "910-219-3377",
            "fax_number": "910-219-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YENCHA",
        "first_name": "MYRON",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101046907",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "201800981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.