Robert G Tayengco, MD
Individual provider Active NPI Internal Medicine Physician · Mason, WV
NPI 1215038401 · NPPES record last updated Jan 23, 2008
Key facts
- NPI
- 1215038401
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 19087 (WV)
- Practice address
- 2007 Second Street
Mason, WV 25260 - Phone
- (304) 773-5195
- Fax
- (304) 675-5167
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 7
Owned or controlled facilities with NPI records 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pleasant Valley Hospital, Inc.
Practice addresses (Care Compare)
2520 Valley Dr
Point Pleasant, WV 25550-2031
Hospital & facility affiliations
- Pleasant Valley Home Health
- Pleasant Valley Home Health
- Adoration Home Health
- Hospice of Huntington
- Rivers Health
- Holzer Medical Center
- St Marys Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Rivers Health |
Hospital | Corporate Director | Oct 1, 2022 |
| Rivers Health |
Hospital | Corporate Director | Oct 1, 2022 |
| Rivers Health |
Hospital | Corporate Director | Jun 1, 2021 |
| Rivers Health Bend Area Clinic |
Rural health clinic | Corporate Director | Oct 1, 2022 |
| Rivers Health Regional Health Center |
Rural health clinic | W-2 Managing Employee | Oct 13, 1997 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100712000477 | WV | Practitioner - Internal Medicine | 5890827786 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19087 | WV | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakin Hospital | Past | Accepting new patients | |
| Pleasant Valley Hospital, Inc. | Past | Accepting new patients | |
| Lakin Wva Facility Operations LLC | Past | Accepting new patients |
Interoperability endpoints
- robert.tayengco@pvhhealth.direct.wvhin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 19087 | WV | Yes |
| 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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000026375 | Other | WA | BCBS |
| 550737600 | Other | WV | COMMERICAL INSURANCE |
| 0080756000 | Medicaid | WV | |
| 2028755 | Medicaid | OH | |
| 230077 | Other | WV | FEDERAL BLACK LUNG |
Other providers in Mason, WV
- Robert Reed
- Derek W Rhodes
- Veronica L Rivas
- Mary Charlene Roach
- Daisy Mae Robinson
- Earnest Leon Trent Jr.
- Wal-Mart Stores East LP
- Anna Nicole Walker
- Deborah Wallen
- Westmoreland Family Care Center, Inc
All providers in Mason, WV · Internal Medicine Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.