Individual provider Active NPI

Patricia Yugueros, M.D.

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Johns Creek, GA
National Provider Identifier
1467494559
Registry record updated Mar 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X
License
052862 Issued in GA
Practice address
6335 Hospital Pkwy
Suite 216
Johns Creek, GA 30097-1549
Phone
(678) 892-7820
Fax
(678) 892-7824
NPI assigned
Jun 12, 2006
Last updated
Mar 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X 052862 GA Primary

Addresses

Primary practice location

6335 Hospital Pkwy
Suite 216
Johns Creek, GA 30097-1549

Mailing address

6335 Hospital Pkwy
Suite 216
Johns Creek, GA 30097-1549
Phone (678) 892-7820

Other identifiers 1

IdentifierTypeStateIssuer
052862OtherGASTATE LICENCE

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
I20050218000391 GA Practitioner - Plastic and Reconstructive Surgery 5193777043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6335 Hospital Pkwy
Suite 216
Johns Creek, GA 30097-1551
Phone (678) 892-7820

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
052862GAMDPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luna Plastic Surgery, PC CurrentSince Apr 14, 2014 Accepting new patients
Artisan Plastic Surgery, LLC Past Accepting new patients
Modern Obstetrics and Gynecology of North Atlanta PC Past Accepting new patients

Locations

6335 Hospital Pkwy
Ste 216
Johns Creek, GA 30097
Phone (678) 892-7820

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267747200000",
    "number": "1467494559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6335 HOSPITAL PKWY",
            "address_2": "SUITE 216",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971549",
            "telephone_number": "678-892-7820",
            "fax_number": "678-892-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6335 HOSPITAL PKWY",
            "address_2": "SUITE 216",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971549",
            "telephone_number": "678-892-7820",
            "fax_number": "678-892-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUGUEROS",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "GA",
            "license": "052862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "052862",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.