Active NPI
Thomas Michael Yatsonsky, DMD
- General Practice Dentistry
- Hawley, PA
National Provider Identifier
1598823148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS026873L
- Practice address
- Rural Route 1 Box 476
Hawley, PA 18428-9732 - Phone
- (570) 685-7170
- Fax
- (570) 685-7170
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS026873L | PA | Primary |
Addresses
Primary practice location
Rural Route 1 Box 476
Hawley, PA 18428-9732
Mailing address
Rural Route 1 Box 476
Hawley, PA 18428-9732
Phone (570) 685-7170
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160419001262 | PA | Order and Referring Only - Dentist | 5597063990 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS026873L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598823148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RURAL ROUTE 1 BOX 476",
"city": "HAWLEY",
"state": "PA",
"postal_code": "184289732",
"telephone_number": "570-685-7170",
"fax_number": "570-685-7170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RURAL ROUTE 1 BOX 476",
"city": "HAWLEY",
"state": "PA",
"postal_code": "184289732",
"telephone_number": "570-685-7170",
"fax_number": "570-685-7170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YATSONSKY",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS026873L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hawley, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.