Active NPI
Elliott A Yolles, MD
- Ophthalmology Physician
- Indianapolis, IN
National Provider Identifier
1326038654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 01025241
- Practice address
- 2020 W 86TH St
Suite 104
Indianapolis, IN 46260-1969 - Phone
- (317) 872-8772
- Fax
- (317) 872-2383
- NPI assigned
- Oct 27, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 01025241 | IN | Primary |
Addresses
Primary practice location
2020 W 86TH St
Suite 104
Indianapolis, IN 46260-1969
Mailing address
2020 W 86TH St
Suite 104
Indianapolis, IN 46260-1969
Phone (317) 872-8772
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100057550 | Medicaid | IN | |
| 182568540 | Other | IN | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01025241 | IN | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199404800000",
"number": "1326038654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 W 86TH ST",
"address_2": "SUITE 104",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462601969",
"telephone_number": "317-872-8772",
"fax_number": "317-872-2383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 W 86TH ST",
"address_2": "SUITE 104",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462601969",
"telephone_number": "317-872-8772",
"fax_number": "317-872-2383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOLLES",
"first_name": "ELLIOTT",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-27",
"last_updated": "2008-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IN",
"license": "01025241",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100057550",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "182568540",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.