Individual provider Active NPI

Brian D Yates, PA

  • Surgical Physician Assistant
  • Temple Terrace, FL
National Provider Identifier
1326345422
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9105927 Issued in FL
Practice address
13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone
(813) 978-9700
Fax
(813) 558-6187
NPI assigned
Feb 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9105927 FL
Surgical Physician Assistant 363AS0400X PA9105927 FL Primary

Addresses

Primary practice location

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925

Mailing address

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone (813) 978-9700

Other identifiers 4

IdentifierTypeStateIssuer
P01054195OtherFLRAILROAD MEDICARE
003307700MedicaidFL
Y06SLOtherFLBCBS
9287689OtherFLAETNA

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9105927FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brian.yates.1@18802.direct.athenahealth.com
  • Direct secure messaging: byates54318@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1326345422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370925",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370925",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "BRIAN",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-25",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105927",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9105927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01054195",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003307700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y06SL",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9287689",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.