Individual provider Active NPI

Edward J Yelinek, PH.D.

  • Psychologist
  • Waynesboro, PA
National Provider Identifier
1629254727
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS004289L Issued in PA
Practice address
131 W 5TH St
Waynesboro, PA 17268-1916
Phone
(717) 762-7719
Fax
(717) 762-1652
NPI assigned
Jan 18, 2008
Last updated
Jan 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS004289L PA Primary

Addresses

Primary practice location

131 W 5TH St
Waynesboro, PA 17268-1916

Mailing address

131 W 5TH St
Waynesboro, PA 17268-1916
Phone (717) 762-7719

Other identifiers 1

IdentifierTypeStateIssuer
0015005680002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

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": "1200614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1629254727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W 5TH ST",
            "city": "WAYNESBORO",
            "state": "PA",
            "postal_code": "172681916",
            "telephone_number": "717-762-7719",
            "fax_number": "717-762-1652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W 5TH ST",
            "city": "WAYNESBORO",
            "state": "PA",
            "postal_code": "172681916",
            "telephone_number": "717-762-7719",
            "fax_number": "717-762-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELINEK",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS004289L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015005680002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.