Individual provider Active NPI

Jennifer C Yolles, MD

  • Psychiatry Physician
  • Saipan, MP
National Provider Identifier
1902942659
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
204426 Issued in NY
Practice address
1 Lower Navy Hill
Saipan, MP 96950
Phone
(315) 832-1728
NPI assigned
Jan 29, 2007
Last updated
Jan 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 204426 NY Primary

Addresses

Primary practice location

1 Lower Navy Hill
Saipan, MP 96950

Mailing address

4325 Hepatica Hill Rd
Manlius, NY 13104-9785
Phone (315) 832-1728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MP
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
I20220606000932 MP Practitioner - Psychiatry 1254422058 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204426NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Healthcare Corporation Current Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Feb 9, 2022 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Feb 9, 2022 Accepting new patients
David a. Thorpe Past Accepting new patients
Professional Practice Group, Dept. of Psych Psychiatry PastSince Jul 1, 1999 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1902942659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 HEPATICA HILL RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049785",
            "telephone_number": "315-832-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LOWER NAVY HILL",
            "city": "SAIPAN",
            "state": "MP",
            "postal_code": "96950",
            "telephone_number": "315-832-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOLLES",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "204426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saipan, MP

Sources for this page

Verify at the official NPI Registry.