NPIMap

Individual provider Active NPI

Robert G Tayengco, MD

  • Internal Medicine Physician
  • Mason, WV
National Provider Identifier
1215038401
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19087 Issued in WV
Practice address
2007 Second Street
Mason, WV 25260
Phone
(304) 773-5195
Fax
(304) 675-5167
NPI assigned
Sep 26, 2006
Last updated
Jan 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19087 WV Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 19087 WV

Addresses

Primary practice location

2007 Second Street
Mason, WV 25260

Mailing address

PO Box 236
PT Pleasant, WV 25550-0236
Phone (304) 675-1020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20100712000477 WV Practitioner - Internal Medicine 5890827786

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pleasant Valley Hospital, Inc.Group PAC ID 2769390236, shared by 3 NPIs, 12 clinicians

Practice addresses (Care Compare)

2520 Valley Dr
Point Pleasant, WV 25550-2031

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19087WVMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakin Hospital Past Accepting new patients
Lakin Wva Facility Operations LLC Past Accepting new patients
Pleasant Valley Hospital, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: robert.tayengco@pvhhealth.direct.wvhin.org

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rivers HealthPT Pleasant, WV, CCN 510012 Hospital Corporate Director Oct 1, 2022
Rivers HealthPoint Pleasant, WV, CCN 51U012 Hospital Corporate Director Oct 1, 2022
Rivers HealthPoint Pleasant, WV, CCN 51T012 Hospital Corporate Director Jun 1, 2021
Rivers Health Bend Area ClinicMason, WV, CCN 513422 Rural health clinic Corporate Director Oct 1, 2022
Rivers Health Regional Health CenterPoint Pleasant, WV, CCN 513427 Rural health clinic W-2 Managing Employee Oct 13, 1997

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 7

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1215038401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "PT PLEASANT",
            "state": "WV",
            "postal_code": "255500236",
            "telephone_number": "304-675-1020",
            "fax_number": "304-675-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 SECOND STREET",
            "city": "MASON",
            "state": "WV",
            "postal_code": "25260",
            "telephone_number": "304-773-5195",
            "fax_number": "304-675-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYENGCO",
        "first_name": "ROBERT",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "19087",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WV",
            "license": "19087",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, WV

Sources for this page

Verify at the official NPI Registry.