Individual provider Active NPI

Jin Soon Yeoh, MD

  • Urology Physician
  • Lawrenceville, GA
National Provider Identifier
1417190901
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
72519 Issued in GA
Practice address
631 Professional Dr Ste 490
Lawrenceville, GA 30046-3370
Phone
(770) 995-0424
Fax
(770) 513-7334
NPI assigned
Apr 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A118495 CA
Urology Physician 208800000X 72519 GA Primary

Addresses

Primary practice location

631 Professional Dr Ste 490
Lawrenceville, GA 30046-3370

Mailing address

1930 Brannan Rd
McDonough, GA 30253-4310
Phone (678) 284-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20141023002355 GA Practitioner - Urology 2163678855 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Jefferson Medical College of Thomas Jefferson University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Georgia Urology, PAGroup PAC ID 8921094376, 99 clinicians
Urological Professional Services, LLCGroup PAC ID 9638391717, 72 clinicians

Practice addresses (Care Compare)

1223 Friendship Rd
Braselton, GA 30517-5608
Phone (678) 205-8387

1600 Medical Way
Suite 220
Snellville, GA 30078-2160
Phone (770) 979-9427

2685 Milscott Dr
Decatur, GA 30033-5906
Phone (404) 292-3727

4450 Calibre Xing NW
Acworth, GA 30101-4103
Phone (770) 607-1893

5730 Glenridge Dr
Suite 200
Atlanta, GA 30328-5579
Phone (404) 256-1844

850 Lawrenceville Suwanee Rd
Lawrenceville, GA 30043-5483

900 Towne Lake Pkwy
Suite 200
Woodstock, GA 30189-1603
Phone (678) 494-9201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.21 of 100Reported as group
Quality
52.19
Promoting interoperability
98
Improvement activities
40
Cost
76.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A118495CAMDUrology Physician
72519GAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urological Professional Services, LLC Urology CurrentSince Nov 1, 2019 Accepting new patients
Georgia Urology PA Urology CurrentSince Nov 1, 2019 Accepting new patients
Georgia Urology, PA CurrentSince Nov 1, 2019 Accepting new patients

Locations

4450 Calibre Xing NW
Acworth, GA 30101
Phone (770) 607-1893

1223 Friendship Rd
Bldg 400
Braselton, GA 30517
Phone (678) 205-8387

1223 Friendship Rd
Ste 100
Braselton, GA 30517
Phone (678) 205-8387

850 Lawrenceville Suwanee Rd
Ste 100
Lawrenceville, GA 30043
Phone (678) 987-0877

850 Lawrenceville Suwanee Rd
Ste 101
Lawrenceville, GA 30043
Phone (770) 963-2451

631 Professional Dr
Ste 490
Lawrenceville, GA 30046
Phone (770) 963-8444

1930 Brannan Rd
McDonough, GA 30253
Phone (678) 284-4040

1600 Medical Way
Ste 220
Snellville, GA 30078
Phone (470) 223-4707

900 Towne Lake Pkwy
Ste 200
Woodstock, GA 30189
Phone (678) 494-9201

Interoperability endpoints

  • Direct secure messaging: jin.yeoh.p1@direct.gupa.nextgenshare.com
  • Direct secure messaging: jinyeoh@nauassocs.medalliesdirect.net

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1417190901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 490",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "770-995-0424",
            "fax_number": "770-513-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEOH",
        "first_name": "JIN SOON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-13",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A118495",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "72519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.