Individual provider Active NPI

Ted H Yamamoto, MD

  • Internal Medicine Physician
  • Lebanon, NH
National Provider Identifier
1689012015
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M-13562 Issued in ID
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 650-5000
NPI assigned
Jun 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X M-13562 ID
Hospitalist Physician 208M00000X MD189146 OR
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X M-13562 ID Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-1000

Other practice location 1

415 6th St
Lewiston, ID 83501-2431
Phone (208) 799-5522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA, OR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170324000712 ID Practitioner - Internal Medicine 2466737960 Reassigns benefits to 1 organization
I20181012002429 WA Practitioner - Hospitalist 2466737960 Reassigns benefits to 2 organizations
I20181130000136 OR Practitioner - Internal MedicinePractitioner - Hospitalist 2466737960 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Harvard Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-2213

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-13562IDMDInternal Medicine Physician
MD189146ORMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Dec 1, 2018 Accepting new patients
Virginia Mason Medical Center CurrentSince May 30, 2024 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Nov 1, 2018 Accepting new patients
Virginia Mason Medical Center Internal Medicine CurrentSince May 30, 2024 Accepting new patients
Sound Physicians of Idaho Internal Medicine CurrentSince Mar 1, 2017 Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Dec 1, 2018 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Providence Health & Services - Oregon Internal Medicine Current Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Dec 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Dec 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Dec 1, 2018 Accepting new patients
Providence Health & Services - Oregon Internal Medicine Current Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Nov 1, 2018 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients

Locations

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

1512 12th Ave Rd
Nampa, ID 83686
Phone (208) 463-5000

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

9205 SW Barnes Rd
Fl 1
Portland, OR 97225
Phone (503) 216-0790

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1689012015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 6th St",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "835012431",
            "country_code": "US",
            "telephone_number": "208-799-5522",
            "fax_number": "208-750-7516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "TED",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-07",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "M-13562",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD189146",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-13562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.