Individual provider Active NPI

Edmund Yu, DPM

  • Podiatrist
  • Stockton, CA
National Provider Identifier
1831620764
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E5615 Issued in CA
Practice address
2545 W Hammer LN
Stockton, CA 95209-2839
Phone
(209) 948-1641
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
No

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Podiatrist 213E00000X E5615 CA Primary

Addresses

Primary practice location

2545 W Hammer LN
Stockton, CA 95209-2839

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (185) 577-1033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201103002579 CA Practitioner - Podiatry 5092125047 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2505 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050

2545 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050

2800 L St
Sacramento, CA 95816-5616

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

815 Court St
Jackson, CA 95642-2154

918 S Fairmont Ave
Lodi, CA 95240-5119
Phone (209) 366-2001

924 S Fairmont Ave
Lodi, CA 95240-5119
Phone (209) 334-2590

Hospital & facility affiliations

  • Dameron Hospital Hospital, Stockton, CA, CCN 050122
  • Sutter Tracy Community Hospital Hospital, Tracy, CA, CCN 050313
  • Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of nail tissue52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5615CAMDPodiatrist
5615CAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern California Orthopaedic Associates Corp Podiatrist CurrentSince Nov 1, 2020 Accepting new patients
Sutter Valley Medical Foundation CurrentSince May 8, 2022 Accepting new patients
Northern California Orthopaedic Associates Corp CurrentSince Nov 1, 2020 Accepting new patients
Sutter Valley Medical Foundation CurrentSince May 8, 2022 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Dignity Health Past Accepting new patients
Dameron Hospital Association Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Community Care Past Accepting new patients
Sutter Tracy Community Hospital Past Accepting new patients

Locations

1061 E Main St
Ste 201
Grass Valley, CA 95945
Phone (530) 477-5288

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

924 S Fairmont Ave
Lodi, CA 95240
Phone (209) 334-2590

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

75 Scripps Dr
Sacramento, CA 95825
Phone (916) 512-6262

2545 W Hammer Ln
Stockton, CA 95209
Phone (209) 948-1641

445 W Eaton Ave
Tracy, CA 95376
Phone (209) 830-4062

Interoperability endpoints

  • Direct secure messaging: eyu565042@hisp.ehr.sutterhealth.org

Organizations & group practices 11

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.

Hospital & facility affiliations 4

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1831620764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "185-577-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092839",
            "telephone_number": "209-948-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "EDMUND",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.