NPIMap

Individual provider Active NPI

Yulia Peniston, DO

  • Obstetrics & Gynecology Physician
  • Chillicothe, MO
National Provider Identifier
1750582516
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2011021726 Issued in MO
Practice address
861 Fairway Dr
Chillicothe, MO 64601-3673
Phone
(913) 680-9830
NPI assigned
May 30, 2007
Last updated
Feb 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2011021726 MO Primary

Addresses

Primary practice location

861 Fairway Dr
Chillicothe, MO 64601-3673

Mailing address

861 Fairway Dr
Chillicothe, MO 64601-3673
Phone (913) 680-9830

Other names 1

  • Yulia Vaksman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110812000116 MO Practitioner - Obstetrics/Gynecology 1850492604 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

861 Fairway Dr
Chillicothe, MO 64601-3673
Phone (913) 680-9830

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Lukes Hospital of Chillicothe Single Specialty CurrentSince Sep 1, 2011 Accepting new patients
General John J Pershing Memorial Hospital Association CurrentSince Apr 29, 2014 Accepting new patients
Cameron Regional Medical Center Inc Single Specialty CurrentSince Jan 2, 2024 Accepting new patients
Cameron Regional Medical Center, Inc. Single Specialty CurrentSince Jan 2, 2024 Accepting new patients
Chillicothe Womens Clinic LLC Single Specialty CurrentSince Jul 12, 2021 Accepting new patients
Saint Lukes Hospital of Chillicothe CurrentSince Sep 1, 2011 Accepting new patients
General John J Pershing Memorial Hospital Association Single Specialty CurrentSince Apr 29, 2014 Accepting new patients
Ozarks Medical Center Single Specialty Past Accepting new patients

Locations

130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050

1600 E Evergreen St
Cameron, MO 64429
Phone (816) 632-2101

2791 N Washington St
Chillicothe, MO 64601
Phone (816) 646-1480

2799 N Washington St
Chillicothe, MO 64601
Phone (660) 214-8300

861 Fairway Dr
Chillicothe, MO 64601
Phone (660) 646-0000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCHGCD/Endpoint/JCHGCD

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1750582516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 FAIRWAY DR",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646013673",
            "telephone_number": "913-680-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 FAIRWAY DR",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646013673",
            "telephone_number": "913-680-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENISTON",
        "first_name": "YULIA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2011021726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YULIA",
            "last_name": "VAKSMAN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chillicothe, MO

Sources for this page

Verify at the official NPI Registry.