Gavan W Yates, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008467 Issued in VA

Practice address

2232 Wilborn Ave Ste C
South Boston, VA 24592-1662

Phone

(434) 517-3910

NPI assigned

May 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Gavan William Yates Other name

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dominion Health Medical AssocGroup PAC ID 1254311558, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Halifax Regional Hospital Hospital, South Boston, VA, CCN 490013

Merit-based Incentive Payment System (MIPS)

Final score

87.02 of 100Reported as group

Quality

66.66

Promoting interoperability

100

Improvement activities

40

Cost

90.08

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gyates746338@direct.sentara.net

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.

• Dominion Health Medical Assoc.

  • Ambulatory Surgical Clinic/Center
  • South Boston, VA
  • NPI 1255771770
  Medicare reassignment Care Compare group
• Dominion Health Medical Assoc

  • Cardiovascular Disease Physician
  • South Boston, VA
  • NPI 1356138879
  NPD
• Dominion Health Medical Associates LTD

  • Non-Surgical Family Planning Clinic/Center
  • South Boston, VA
  • NPI 1992244172
  NPD (past)

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

• Halifax Regional Hospital, Inc.

  • General Acute Care Hospital
  • South Boston, VA
  • NPI 1588668842
  Care Compare affiliation

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1700451655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 WILBORN AVE STE C",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921662",
            "telephone_number": "434-517-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 WILBORN AVE STE C",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921662",
            "telephone_number": "434-517-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "GAVAN",
        "middle_name": "W",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAVAN",
            "last_name": "YATES",
            "middle_name": "WILLIAM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joan Wilson, MD
• James F Witko, MD, FCCP
• Women'S Health Center PC
• Marcia Marie Wood
• Kaitlyn Woodard
• Nicole Faye Yeshtokin, DO
• Amanda Young, SERVICES FACILITATOR
• Sang H Yu, D.D.S.
• Yaning Zhang, MD

• Physician Assistant in South Boston, VA
• Providers in South Boston, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.