Individual provider Active NPI

Michelle M Yamada, PA

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1487735403
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4303 Issued in GA
Practice address
5201 Frederick Street
Savannah, GA 31405-4501
Phone
(912) 351-3030
Fax
(912) 351-3039
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4303 GA
Otolaryngology Physician 207Y00000X 004303 GA
Physician Assistant 363A00000X 4303 GA Primary

Addresses

Primary practice location

5201 Frederick Street
Savannah, GA 31405-4501

Mailing address

5201 Frederick Street
Savannah, GA 31405-4501
Phone (912) 351-3030

Other identifiers 2

IdentifierTypeStateIssuer
275998532AMedicaidGA
344049OtherGAMEDICAID WELLCARE HMO #

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040909000415 GA Practitioner - Physician Assistant 3577539626 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians
Effingham Rehab Services, LLCGroup PAC ID 5597752063, shared by 3 NPIs, 143 clinicians

Practice addresses (Care Compare)

1000 Towne Ctr Blvd
Suite 200
Pooler, GA 31322-4059
Phone (912) 351-3030

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

123 Canal St
Suite 203
Pooler, GA 31322-4104
Phone (912) 988-1283

5201 Frederick St
Savannah, GA 31405-4501
Phone (912) 351-3030

Hospital & facility affiliations

  • St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004303GAMDOtolaryngology Physician
4303GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Aug 9, 2024 Accepting new patients
Ear, Nose & Throat Associates of Savannah, P.C. Otolaryngology CurrentSince Dec 28, 2015 Accepting new patients
Ear, Nose & Throat Associates of Savannah, PC Otolaryngology CurrentSince Dec 28, 2015 Accepting new patients
Ear, Nose & Throat Associates of Savannah, PC Otolaryngology Past Accepting new patients

Locations

3715 Northside Pkwy NW
Bldg 100
Atlanta, GA 30327
Phone (404) 262-7414

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

1000 Towne Center Blvd
Ste 200
Pooler, GA 31322
Phone (912) 330-8075

5201 Frederick St
Savannah, GA 31405

Interoperability endpoints

  • Direct secure messaging: michelle.yamada.1@8042.direct.athenahealth.com

Organizations & group practices 6

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 1

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1487735403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 FREDERICK STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054501",
            "telephone_number": "912-351-3030",
            "fax_number": "912-351-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 FREDERICK STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054501",
            "telephone_number": "912-351-3030",
            "fax_number": "912-351-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMADA",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "4303",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "004303",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "4303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275998532A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WELLCARE HMO #",
            "identifier": "344049",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.