Individual provider Active NPI

Yohannes W. Yesus, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Jeffersonville, IN
National Provider Identifier
1679665749
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01051747 Issued in IN
Practice address
1220 Missouri Ave
Pathology Dept
Jeffersonville, IN 47130-3725
Phone
(812) 283-2169
Fax
(502) 456-4440
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 36204 KY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01051747 IN Primary

Addresses

Primary practice location

1220 Missouri Ave
Pathology Dept
Jeffersonville, IN 47130-3725

Mailing address

1169 Eastern Pkwy
Suite G71
Louisville, KY 40217-1417
Phone (502) 456-6212

Other identifiers 6

IdentifierTypeStateIssuer
64021199MedicaidKY
200268960AMedicaidIN
3471714000OtherKYPASSPORT ADVANTAGE
P00430453OtherINMEDICARE RR
50022834OtherKYPASSPORT
000000528992OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240813001079 GA Practitioner - Pathology 7517068885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01051747INMDAnatomic Pathology & Clinical Pathology Physician
36204KYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince May 7, 2024 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince May 7, 2024 Accepting new patients
Pathgroup Labs, LLC Past Accepting new patients
Associated Pathologists LLC Past Accepting new patients
East Louisville Pathologists PSC Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Organizations & group practices 5

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1679665749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 EASTERN PKWY",
            "address_2": "SUITE G71",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171417",
            "telephone_number": "502-456-6212",
            "fax_number": "502-456-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MISSOURI AVE",
            "address_2": "PATHOLOGY DEPT",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303725",
            "telephone_number": "812-283-2169",
            "fax_number": "502-456-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YESUS",
        "first_name": "YOHANNES",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "36204",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01051747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64021199",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200268960A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "3471714000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00430453",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50022834",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000528992",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.