Individual provider Active NPI

Michael Anthony Yodice, MD

  • Internal Medicine Physician
  • Danville, PA
National Provider Identifier
1538747795
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT223743 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-9800
Phone
(570) 271-6787
NPI assigned
Mar 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MT223743 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-9800

Mailing address

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210630000302 PA Order and Referring Only - GastroenterologyPractitioner - GastroenterologyPractitioner - Internal Medicine 6204237118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT223743PAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1538747795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODICE",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT223743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.