Active NPI
Chuck Yadmark, MD
- Internal Medicine Physician
- Livonia, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- CY063359
- Practice address
- 31610 Plymouth Rd
Livonia, MI 48150-1930 - Phone
- (734) 421-2840
- Fax
- (734) 421-4045
- NPI assigned
- Aug 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | CY063359 | MI | Primary |
Addresses
Primary practice location
31610 Plymouth Rd
Livonia, MI 48150-1930
Mailing address
31610 Plymouth Rd
Livonia, MI 48150-1932
Phone (734) 421-2840
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CY063359 | Other | MI | STATE LICENSE |
| 080H24860 | Other | MI | BLUE CROSS BLUE SHIELD |
| 383344395 | Other | MI | TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Michigan Medical School, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
31610 Plymouth Rd
Livonia, MI 48150-1930
Phone (734) 421-2840
4350 Jackson Rd
Suite 230
Ann Arbor, MI 48103-1890
Phone (734) 887-4396
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CY063359 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iha Health Service Corporation | Current | Accepting new patients | |
| Iha Health Services Corporation | Current | Accepting new patients | |
| Iha Health Services Corporation | Current | Accepting new patients |
Locations
4350 Jackson Rd
Ste 230
Ann Arbor, MI 48103
Phone (734) 887-4396
24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400
2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840
128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677
1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000
44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700
Interoperability endpoints
- cyadmark206105@direct.trinity-health.org
Organizations & group practices 4
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.
-
dba IHA Canton Obstetrics and Gynecology
- Obstetrics & Gynecology Physician
- Canton, MI
- NPI 1457408965
-
- Internal Medicine Physician
- Livonia, MI
- NPI 1639656184
-
dba Trinity Health IHA Medical Group OB/GYN Float
- Obstetrics & Gynecology Physician
- Ypsilanti, MI
- NPI 1831053701
-
dba IHA Urgent Care-Domino's Farms
- Urgent Care Clinic/Center
- Ann Arbor, MI
- NPI 1992937023
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Trinity Heath Ann Arbor Hospital
- General Acute Care Hospital
- Ypsilanti, MI
- NPI 1780658443
-
- General Acute Care Hospital
- Livonia, MI
- NPI 1790706901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697500800000",
"number": "1891803029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31610 PLYMOUTH RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481501932",
"telephone_number": "734-421-2840",
"fax_number": "734-421-4045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31610 PLYMOUTH RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481501930",
"telephone_number": "734-421-2840",
"fax_number": "734-421-4045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YADMARK",
"first_name": "CHUCK",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-28",
"last_updated": "2023-10-17",
"certification_date": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "CY063359",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "CY063359",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "080H24860",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "383344395",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.