Organization Active NPI

Yorktowne Urology, PC

  • Specialist
  • York, PA
National Provider Identifier
1649357278
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
YORKTOWNE UROLOGY, PC
Practice address
2350 Freedom Way
Suite 102
York, PA 17402
Phone
(717) 741-9536
Fax
(717) 741-5509
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Mrs. Carolyn S Roggenbaum
Title
Practice Manager
Phone
(717) 741-9536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

2350 Freedom Way
Suite 102
York, PA 17402

Mailing address

2350 Freedom Way
Suite 102
York, PA 17402
Phone (717) 741-9536

Other identifiers 3

IdentifierTypeStateIssuer
02502300OtherPACAPITAL BLUECROSS GROUP
1007713350010MedicaidPA
664700OtherPAHIGHMARK BLUESHIELD GROUP

National Provider Directory

National Provider Directory

Locations

100 Kestrel Dr
Ste E
Collegeville, PA 19426
Phone (610) 831-5354

2350 Freedom Way
Ste 102
York, PA 17402
Phone (717) 741-9536

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1649357278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 FREEDOM WAY",
            "address_2": "SUITE 102",
            "city": "YORK",
            "state": "PA",
            "postal_code": "17402",
            "telephone_number": "717-741-9536",
            "fax_number": "717-741-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 FREEDOM WAY",
            "address_2": "SUITE 102",
            "city": "YORK",
            "state": "PA",
            "postal_code": "17402",
            "telephone_number": "717-741-9536",
            "fax_number": "717-741-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YORKTOWNE UROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "ROGGENBAUM",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "717-741-9536",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUECROSS GROUP",
            "identifier": "02502300",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007713350010",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUESHIELD GROUP",
            "identifier": "664700",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.