Individual provider Active NPI

Niti Yogesh, PA-C

  • Physician Assistant
  • Dresden, TN
National Provider Identifier
1669963674
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2018016911 Issued in MO
Practice address
130 E. Locust St.
Dresden, TN 38225
Phone
(731) 364-3196
Fax
(731) 364-5359
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MO
Physician Assistant 363A00000X 2018016911 MO Primary

Addresses

Primary practice location

130 E. Locust St.
Dresden, TN 38225

Mailing address

130 E. Locust St.
Dresden, TN 38225
Phone (731) 364-3196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191122002721 TN Practitioner - Physician Assistant 1951658475 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvoair Medical PCGroup PAC ID 1557742368, 17 clinicians

Practice addresses (Care Compare)

130 E Locust St
Dresden, TN 38225-1467
Phone (833) 688-6247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3889TNMDOptometrist
2018016911MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvoair Medical PC CurrentSince Mar 1, 2024 Accepting new patients
Nuvoair Medical PC CurrentSince Mar 1, 2024 Accepting new patients

Locations

50 Milk St
Fl 16
Boston, MA 02109
Phone (617) 213-0335

130 E Locust St
Dresden, TN 38225
Phone (731) 364-3196

Interoperability endpoints

  • Direct secure messaging: niti.baker.1@27550.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/27550/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1669963674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E. LOCUST ST.",
            "city": "DRESDEN",
            "state": "TN",
            "postal_code": "38225",
            "telephone_number": "731-364-3196",
            "fax_number": "731-364-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E. LOCUST ST.",
            "city": "DRESDEN",
            "state": "TN",
            "postal_code": "38225",
            "telephone_number": "731-364-3196",
            "fax_number": "731-364-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOGESH",
        "first_name": "NITI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2018016911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dresden, TN

Sources for this page

Verify at the official NPI Registry.