Kenneth Eric Yagodich, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01037698A Issued in IN

Practice address

14020 Old State Rd Ste C100
Evansville, IN 47725-1171

Phone

(812) 469-4765

NPI assigned

Feb 10, 2007

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Family Practice

Education

Temple University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Easter Seals Rehabilitation Center IncGroup PAC ID 8426135179, shared by 3 NPIs, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension at Home Home health agency, Evansville, IN, CCN 157281
• Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100
• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
• Gibson General Hospital Hospital, Princeton, IN, CCN 151319
• Wabash General Hospital 1 Hospital, Mount Carmel, IL, CCN 141327
• The Women'S Hospital Hospital, Newburgh, IN, CCN 150149

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as apm

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Mary'S Medical Group, LLC

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1164852539
  Medicare reassignment Care Compare group NPD
• St Mary'S Medical Group, LLC

  • Nephrology Physician
  • Evansville, IN
  • NPI 1619307873
  NPD
• St. Mary'S Health, Inc

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1497706287

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Hospital Inc

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427
  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642
  Care Compare affiliation
• Deaconess Women'S Hospital of Southern Indiana, LLC

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1114023512
  Care Compare affiliation
• Gibson General Hospital Inc.

  • Critical Access Hospital
  • Princeton, IN
  • NPI 1558346007
  Care Compare affiliation
• St. Mary'S at Home, LLC

  • Home Health Agency
  • Evansville, IN
  • NPI 1780687061
  Care Compare affiliation
• St. Mary'S Health, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1427082957
  Care Compare affiliation
• Wabash General Hospital District

  • Critical Access Hospital
  • Mount Carmel, IL
  • NPI 1194728808
  Care Compare affiliation
• Wabash General Hospital District

  • Ambulance
  • Mount Carmel, IL
  • NPI 1194814178

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1578604633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14020 OLD STATE RD STE C100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477251171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14020 OLD STATE RD STE C100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477251171",
            "telephone_number": "812-469-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGODICH",
        "first_name": "KENNETH",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-10",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01037698A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenneth.yagodich.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "14020 Old State Rd Ste C100",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477251171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Philip A Wuertz, LCSW
• Peter Wulff, DMD
• John W Wy, MD
• Brandon Wynn, DO
• Dejun Xu, M.D.
• Jackeline Michelle Yagual Flores, MS, OTR/L
• Hongyu Yang, MD
• Mei Yang, FNP
• Sumera Yaqub, M.D.
• Erin Michelle Yarbor, MS,CCCSLP

• Family Medicine Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.