Individual provider Active NPI

William Peter Yeomans, DDS

  • Dentist
  • Scranton, PA
National Provider Identifier
1376755355
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS018595L Issued in PA
Practice address
959 Wyoming Ave.
Scranton Primary Health Care Center
Scranton, PA 18509-3023
Phone
(570) 504-0882
Fax
(570) 504-0859
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS018595L PA Primary

Addresses

Primary practice location

959 Wyoming Ave.
Scranton Primary Health Care Center
Scranton, PA 18509-3023

Mailing address

P.O. Box 31 959 Wyoming Ave.
Scranton Primary Health Care Center
Scranton, PA 18501-0031
Phone (570) 344-3517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151209002860 PA Practitioner - Oral Surgery 4880995166 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS018595LPAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Scranton Primary Health Care Center, Inc. Current Accepting new patients
Scranton Primary Health Care Center, Inc. CurrentSince Nov 2, 2015 Accepting new patients
Scranton Primary Health Care Center, Inc CurrentSince Nov 2, 2015 Accepting new patients

Locations

959 Wyoming Ave
Scranton, PA 18509
Phone (570) 344-3517

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1376755355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 31 959 WYOMING AVE.",
            "address_2": "SCRANTON PRIMARY HEALTH CARE CENTER",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185010031",
            "telephone_number": "570-344-3517",
            "fax_number": "570-344-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 WYOMING AVE.",
            "address_2": "SCRANTON PRIMARY HEALTH CARE CENTER",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185093023",
            "telephone_number": "570-504-0882",
            "fax_number": "570-504-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEOMANS",
        "first_name": "WILLIAM",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS018595L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.