Yutao Deng, M.D.,

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

117 South 11TH Street
204 Pavilion
Philadelphia, PA 19107

Phone

(215) 503-3876

Fax

(215) 955-2519

NPI assigned

Jun 17, 2022

Reactivated

May 16, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1558092973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 SOUTH 11TH STREET",
            "address_2": "204 PAVILION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-503-3876",
            "fax_number": "215-955-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 SOUTH 11TH STREET",
            "address_2": "204 PAVILION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-503-3876",
            "fax_number": "215-955-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENG",
        "first_name": "YUTAO",
        "name_prefix": "Mr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-17",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "deactivation_date": "2023-03-08",
        "reactivation_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denco Home Care Services
• Jiawei Deng
• Lily Deng, MD
• Sibao Deng
• Yao Deng
• Daniel William Dengel, PH.D.
• April Marie Dengler, CRNP
• E Joseph Denham, D.O.
• Richard Paul Denicola, M.D.
• Amanda Deniger, NP

• Student in an Organized Health Care Education/Training Program in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Student in an Organized Health Care Education/Training Program in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.