Individual provider Active NPI

Eva L Youshock, MD

  • Dermatology Physician
  • Rochester Hills, MI
National Provider Identifier
1760417679
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301049372 Issued in MI
Practice address
6700 N Rochester Rd
Ste 212
Rochester Hills, MI 48306
Phone
(248) 650-1510
Fax
(248) 650-1526
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 4301049372 MI Primary

Addresses

Primary practice location

6700 N Rochester Rd
Ste 212
Rochester Hills, MI 48306

Mailing address

820 Springer Dr
Lombard, IL 60148-6413
Phone (708) 634-4602

Other practice location 1

2785 N Ankeny Blvd Ste 24
Ankeny, IA 50023-4705
Phone (515) 964-5503

Other practice location 2

500 Main St Ste 113
Ames, IA 50010-6083
Phone (515) 232-3006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Audrey Bruell, M.D. P.C. Dermatology Current Accepting new patients

Locations

37605 Pembroke Ave
Livonia, MI 48152
Phone (734) 591-7931

Interoperability endpoints

  • Direct secure messaging: eva.youshock@forefrontdermatology.emadirect.md

Organizations & group practices 1

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1760417679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SPRINGER DR",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486413",
            "telephone_number": "708-634-4602",
            "fax_number": "630-495-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 N ROCHESTER RD",
            "address_2": "STE 212",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "48306",
            "telephone_number": "248-650-1510",
            "fax_number": "248-650-1526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2785 N Ankeny Blvd Ste 24",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "500234705",
            "country_code": "US",
            "telephone_number": "515-964-5503",
            "fax_number": "515-232-3009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Main St Ste 113",
            "address_purpose": "LOCATION",
            "city": "Ames",
            "state": "IA",
            "postal_code": "500106083",
            "country_code": "US",
            "telephone_number": "515-232-3006",
            "fax_number": "515-232-3009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUSHOCK",
        "first_name": "EVA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301049372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.