Individual provider Active NPI

Mark Lowell Yelderman, M.D.

  • Occupational Medicine Physician
  • Addison, TX
National Provider Identifier
1386933109
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
1973 Issued in TX
Practice address
15800 Midway Rd
Addison, TX 75001-4259
Phone
(855) 835-6337
Fax
(844) 371-8990
NPI assigned
Apr 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 1973 TX Primary

Addresses

Primary practice location

15800 Midway Rd
Addison, TX 75001-4259

Mailing address

PO Box 4432
McCall, ID 83638-4432
Phone (214) 952-3018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120817000248 TX Practitioner - Anesthesiology 2062668403 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1973TXMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care, P.a. Current Accepting new patients
Aransas Spine Care Current Accepting new patients
American Current Care PA CurrentSince Oct 19, 2015 Accepting new patients
Victoria Emergency Partners LLC CurrentSince May 7, 2016 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jan 16, 2016 Accepting new patients
Victoria Emergency Associates LLC CurrentSince Jul 23, 2016 Accepting new patients
Concord Medical Group PLLC CurrentSince Jan 16, 2016 Accepting new patients
American Current Care P.a. CurrentSince Oct 19, 2015 Accepting new patients
Medical Center Emergency Physicians PA Past Accepting new patients

Locations

15810 Midway Rd
Addison, TX 75001
Phone (972) 458-8111

4025 Spid Dr
Corpus Christi, TX 78411
Phone (361) 852-8255

1002 Abc Ave
Ste 600
Freeport, TX 77541
Phone (979) 233-6571

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

12345 Katy Fwy
Houston, TX 77079
Phone (281) 679-5600

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

Interoperability endpoints

  • Direct secure messaging: mly@direct.meditouchehr.com

Organizations & group practices 9

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": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1386933109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4432",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836384432",
            "telephone_number": "214-952-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15800 MIDWAY RD",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014259",
            "telephone_number": "855-835-6337",
            "fax_number": "844-371-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELDERMAN",
        "first_name": "MARK",
        "middle_name": "LOWELL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "TX",
            "license": "1973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

Verify at the official NPI Registry.