Yvonne Baum M.D., P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

J6823 Issued in TX

Legal business name

YVONNE BAUM M.D., P.A.

Practice address

700 Olympic Plaza Cir
Suite 912
Tyler, TX 75701-1951

Phone

(903) 596-3808

Fax

(903) 561-0836

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Yvonne Baum, M.D.NPI 1679572614

Title

Owner

Phone

(903) 596-3808

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yvonne Baum, M.D.

  • Internal Medicine Physician
  • Tyler, TX
  • NPI 1679572614
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1659469773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR",
            "address_2": "SUITE 912",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011951",
            "telephone_number": "903-596-3808",
            "fax_number": "903-561-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR",
            "address_2": "SUITE 912",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011951",
            "telephone_number": "903-596-3808",
            "fax_number": "903-561-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YVONNE BAUM M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "BAUM",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-596-3808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "J6823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0078MG",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171295201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Tyler, TX
• Providers in Tyler, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.