Individual provider Active NPI

Robert J Yu, D.M.D.

  • Periodontics
  • St Petersburg, FL
National Provider Identifier
1568509941
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
17038 Issued in FL
Practice address
6700 Crosswinds Dr N
Suite 200B
St Petersburg, FL 33710-8602
Phone
(727) 384-9122
Fax
(727) 384-9127
NPI assigned
Feb 1, 2007
Last updated
Jun 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 17038 FL Primary

Addresses

Primary practice location

6700 Crosswinds Dr N
Suite 200B
St Petersburg, FL 33710-8602

Mailing address

6700 Crosswinds Dr N
Suite 200B
St Petersburg, FL 33710-8602
Phone (727) 384-9122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Mar 16, 2015 through Mar 16, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17038FLMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Bay Dental Implants & Periodontics, PL Past Accepting new patients

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1568509941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 CROSSWINDS DR N",
            "address_2": "SUITE 200B",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108602",
            "telephone_number": "727-384-9122",
            "fax_number": "727-384-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 CROSSWINDS DR N",
            "address_2": "SUITE 200B",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108602",
            "telephone_number": "727-384-9122",
            "fax_number": "727-384-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "17038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.