Active NPI
Mark L Yeske, D.P.M.
- Podiatrist
- Pendleton, OR
National Provider Identifier
1366400517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- DP00171
- Practice address
- 714 SW Dorion Ave
Pendleton, OR 97801-2039 - Phone
- (541) 276-2372
- Fax
- (541) 276-2411
- NPI assigned
- May 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | DP00171 | OR | Primary |
| Foot Surgery Podiatrist | 213ES0131X | DP00171 | OR |
Addresses
Primary practice location
714 SW Dorion Ave
Pendleton, OR 97801-2039
Mailing address
3436 NE Riverside School St
Pendleton, OR 97801-3463
Phone (541) 276-6740
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48431001 | Other | OR | BLUE CROSS OF OREGON |
| 162099 | Medicaid | OR | |
| 480033064 | Other | OR | RAILROAD MEDICARE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DP00171 | OR | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282608000000",
"number": "1366400517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3436 NE RIVERSIDE SCHOOL ST",
"city": "PENDLETON",
"state": "OR",
"postal_code": "978013463",
"telephone_number": "541-276-6740",
"fax_number": "541-276-2411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 SW DORION AVE",
"city": "PENDLETON",
"state": "OR",
"postal_code": "978012039",
"telephone_number": "541-276-2372",
"fax_number": "541-276-2411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YESKE",
"first_name": "MARK",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2010-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "OR",
"license": "DP00171",
"primary": true
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "OR",
"license": "DP00171",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF OREGON",
"identifier": "48431001",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "162099",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "480033064",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pendleton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.