Individual provider Active NPI

Paul T Yoder, MD

  • Family Medicine Physician
  • Payson, AZ
National Provider Identifier
1780779991
Registry record updated Feb 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31473 Issued in AZ
Practice address
904 N Overlook Cir
Payson, AZ 85541-6601
Phone
(928) 363-1173
Fax
(928) 363-1173
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31473 AZ Primary

Addresses

Primary practice location

904 N Overlook Cir
Payson, AZ 85541-6601

Mailing address

904 N Overlook Cir
Payson, AZ 85541-6601
Phone (928) 363-1173

Other identifiers 1

IdentifierTypeStateIssuer
AZ0735560OtherAZBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040116000802 AZ Practitioner - Family Practice 6800797424 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31473AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare, Inc. CurrentSince Sep 1, 2017 Accepting new patients
North Country Healthcare, Inc. Current Accepting new patients
North Country Healthcare, Inc. Family Medicine Current Accepting new patients
North Country Healthcare, Inc. CurrentSince Sep 1, 2017 Accepting new patients
Nextcare Arizona I JV LLC Current Accepting new patients
Nextcare Arizona LLC CurrentSince Jun 20, 2015 Accepting new patients

Locations

2080 W Southern Ave
Bldg A1
Apache Junction, AZ 85120
Phone (480) 985-0172

474 N US Highway 89
Chino Valley, AZ 86323
Phone (520) 636-4355

450 S Willard St
Ste 120
Cottonwood, AZ 86326
Phone (928) 634-2574

1000 N Humphreys St
Ste 104
Flagstaff, AZ 86001
Phone (928) 779-3844

2500 N Rose St
Flagstaff, AZ 86004
Phone (928) 213-6121

399 S Malpais Ln
Ste 100
Flagstaff, AZ 86001
Phone (928) 286-8830

1810 Mesquite Ave
Ste B
Lk Havasu Cty, AZ 86403
Phone (928) 453-4600

126 E Main St
Ste B
Payson, AZ 85541
Phone (928) 472-3700

914 N Scottsdale Rd
Ste 104
Tempe, AZ 85288
Phone (480) 776-1620

9525 E Old Spanish Trl
Ste 101
Tucson, AZ 85748
Phone (520) 731-3666

620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700

1394 W 16th St
Yuma, AZ 85364
Phone (928) 539-0055

Organizations & group practices 6

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645920000000",
    "number": "1780779991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 N OVERLOOK CIR",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855416601",
            "telephone_number": "928-363-1173",
            "fax_number": "928-363-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 N OVERLOOK CIR",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855416601",
            "telephone_number": "928-363-1173",
            "fax_number": "928-363-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODER",
        "first_name": "PAUL",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-02-27",
        "certification_date": "2022-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "31473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "AZ0735560",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, AZ

Sources for this page

Verify at the official NPI Registry.