Paul L Yudelman, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME0059823 Issued in FL

Practice address

12318 McGregor Woods Cir
Fort Myers, FL 33908-2440

Phone

(239) 209-0669

NPI assigned

Aug 22, 2005

Last updated

Jan 3, 2019By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Outpatient Anesthesia Specialists LLC

  • Endoscopy Clinic/Center
  • Fort Myers, FL
  • NPI 1700033537
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1578555918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12318 MCGREGOR WOODS CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339082440",
            "telephone_number": "239-209-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12318 MCGREGOR WOODS CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339082440",
            "telephone_number": "239-209-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUDELMAN",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME0059823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "11927W",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "K7665",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00232932",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052480800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Yount, PHARMD
• Youworth Inc
• Austin Robert Ysidro, PA-C
• Hsin-Cheng Yu, MD
• Xiaohong Yu, M.D.
• Lynn Yurchak, OTR/L
• Joseph Froilan Yurich, M.D.
• Michael Yurich, CN
• Hailey L Yzaguirre, LCSW
• Z Health Solution

• Gastroenterology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.