Michael E Yencho, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

033291 Issued in CT

Practice address

239 Merrow Rd
Tolland, CT 06084-3915

Phone

(860) 875-9856

Fax

(860) 875-9868

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Tolland County Pediatrics & Adolescent Medicine, LLC

  • Pediatric Adolescent Medicine Physician
  • Tolland, CT
  • NPI 1619181500
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1821018847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 MERROW RD",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060843915",
            "telephone_number": "860-875-9856",
            "fax_number": "860-875-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 MERROW RD",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060843915",
            "telephone_number": "860-875-9856",
            "fax_number": "860-875-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YENCHO",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CT",
            "license": "033291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1332915",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monnica T Williams, PHD
• Winfield S Danielson Jr DDS
• Woodwinds of Tolland, Inc
• Kyle Wytas, PHARMD
• Karen Yarosh
• Savannah Zell, RN

• Pediatric Adolescent Medicine Physician in Tolland, CT
• Providers in Tolland, CT by specialty
• Pediatric Adolescent Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.