Individual provider Active NPI

Wankin J Yu, MD

  • Gastroenterology Physician
  • Leominster, MA
National Provider Identifier
1477639656
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
059212 Issued in MA
Practice address
105 Erdman Way
Leominster, MA 01453
Phone
(978) 466-7800
Fax
(978) 466-9333
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 059212 MA Primary

Addresses

Primary practice location

105 Erdman Way
Leominster, MA 01453

Mailing address

105 Erdman Way
Leominster, MA 01453
Phone (978) 466-7800

Other identifiers 6

IdentifierTypeStateIssuer
110026291OtherRAILROAD MEDICARE
30299OtherHARVARD PILGRIM
J07107OtherBLUE CROSS
3033970MedicaidMA
5090OtherFALLON COMMUNITY
059212OtherTUFTS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040428000413 MA Practitioner - Gastroenterology 5294722609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Worcester Gastroenterology, P.C.Group PAC ID 7113069899, 4 clinicians

Practice addresses (Care Compare)

105 Erdman Way
Leominster, MA 01453-1805
Phone (978) 466-7800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
059212MAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Worcester Gastroenterology PC Gastroenterology Current Accepting new patients
Central Massachusetts Ambulatory Endoscopy Center LLC CurrentSince Jul 1, 2010 Accepting new patients
North Worcester Gastroenterology, P.C. Gastroenterology CurrentSince Jan 1, 2010 Accepting new patients

Locations

105 Erdman Way
Leominster, MA 01453
Phone (978) 466-7800

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1477639656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ERDMAN WAY",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-7800",
            "fax_number": "978-466-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ERDMAN WAY",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-7800",
            "fax_number": "978-466-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "WANKIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "059212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110026291",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "30299",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J07107",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3033970",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY",
            "identifier": "5090",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "059212",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.