Individual provider Active NPI

Leon Jay Yoder, DO

  • Gastroenterology Physician
  • Wagoner, OK
National Provider Identifier
1285621482
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
1728 Issued in OK
Practice address
1202 W Cherokee St Ste C
Wagoner, OK 74467-4629
Phone
(918) 485-1205
Fax
(918) 485-1695
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 1728 OK Primary

Addresses

Primary practice location

1202 W Cherokee St Ste C
Wagoner, OK 74467-4629

Mailing address

1200 W Cherokee St
Wagoner, OK 74467-4624
Phone (918) 485-1205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20070221000147 OK Practitioner - Gastroenterology 1951302132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wagoner Hospital AuthorityGroup PAC ID 0042217531, 20 clinicians

Practice addresses (Care Compare)

1200 W Cherokee St
Wagoner, OK 74467-4624
Phone (918) 485-5514

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1728OKMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wagoner Hospital Authority CurrentSince Sep 1, 2021 Accepting new patients
Wagoner Hospital Authority CurrentSince Sep 1, 2021 Accepting new patients

Locations

1202 W Cherokee St
Ste C
Wagoner, OK 74467
Phone (918) 485-1205

1200 W Cherokee St
Wagoner, OK 74467
Phone (918) 485-1240

1202 W Cherokee St
Ste D
Wagoner, OK 74467
Phone (918) 485-0091

Interoperability endpoints

  • Direct secure messaging: leon.yoder.1@14254.direct.athenahealth.com

Organizations & group practices 2

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 2

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1285621482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W CHEROKEE ST",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674624",
            "telephone_number": "918-485-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W CHEROKEE ST STE C",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674629",
            "telephone_number": "918-485-1205",
            "fax_number": "918-485-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODER",
        "first_name": "LEON",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OK",
            "license": "1728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wagoner, OK

Sources for this page

Verify at the official NPI Registry.