Organization Active NPI

Dr. Micheal Yankowitz LLC

  • Foot & Ankle Surgery Podiatrist
  • Festus, MO
National Provider Identifier
1487987210
Registry record updated Sep 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000621 Issued in MO
Legal business name
DR. MICHEAL YANKOWITZ LLC
Practice address
1216 W Main St
Festus, MO 63028-1654
Phone
(636) 933-4100
Fax
(636) 937-3788
NPI assigned
Sep 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2009

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

Authorized official

Name
Dr. Michael Yankowitz, DPMNPI 1790719128
Title
Owner
Phone
(636) 933-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 000621 MO Primary

Addresses

Primary practice location

1216 W Main St
Festus, MO 63028-1654

Mailing address

PO Box 68
1216 West Main St
Festus, MO 63028-0068
Phone (636) 933-4100

Other identifiers 1

IdentifierTypeStateIssuer
303003206MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091102000582 MO Part B Supplier - Clinic/Group Practice 1153468616 Receives reassigned benefits from 1 practitioner
Practice locations: Cedar Hill, MO; Festus, MO

National Provider Directory

National Provider Directory

Locations

1216 W Main St
Festus, MO 63028
Phone (314) 525-4611

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252627200000",
    "number": "1487987210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "address_2": "1216 WEST MAIN ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630280068",
            "telephone_number": "636-933-4100",
            "fax_number": "636-937-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 W MAIN ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281654",
            "telephone_number": "636-933-4100",
            "fax_number": "636-937-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MICHEAL YANKOWITZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-11",
        "last_updated": "2009-09-11",
        "status": "A",
        "authorized_official_last_name": "YANKOWITZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-933-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "000621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303003206",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.