Individual provider Active NPI

Steven M Yellin, D.P.M

  • Foot Surgery Podiatrist
  • Martinsville, VA
National Provider Identifier
1508809633
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
0103000370 Issued in VA
Practice address
1001 Brookdale St
Martinsville, VA 24112-3901
Phone
(276) 638-2202
Fax
(276) 638-8251
NPI assigned
Jun 14, 2006
Last updated
Dec 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 0103000370 VA Primary

Addresses

Primary practice location

1001 Brookdale St
Martinsville, VA 24112-3901

Mailing address

1001 Brookdale St
Martinsville, VA 24112-3901
Phone (276) 638-2202

Other identifiers 1

IdentifierTypeStateIssuer
009301275MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0103000370VAMDFoot Surgery Podiatrist

Organizations & group practices 1

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1508809633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BROOKDALE ST",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241123901",
            "telephone_number": "276-638-2202",
            "fax_number": "276-638-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BROOKDALE ST",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241123901",
            "telephone_number": "276-638-2202",
            "fax_number": "276-638-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLIN",
        "first_name": "STEVEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103000370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009301275",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.