Individual provider Active NPI

Jason Yanofski, MD

  • Psychiatry Physician
  • Baltimore, MD
National Provider Identifier
1922147438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
T4766 Issued in MD
Practice address
1031 S Bouldin St
Baltimore, MD 21224-5022
Phone
(214) 888-7524
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 T4766 MD Primary

Addresses

Primary practice location

1031 S Bouldin St
Baltimore, MD 21224-5022

Mailing address

1031 S Bouldin St
Baltimore, MD 21224-5022
Phone (214) 888-7524

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221020001503 CA Practitioner - Psychiatry 8729454483 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T4766MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Jul 8, 2022 Accepting new patients
Department of State Hospitals CurrentSince Jul 8, 2022 Accepting new patients
Department of State Hospitals Current Accepting new patients

Locations

2100 Napa Vallejo Hwy
Napa, CA 94558
Phone (707) 253-5000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Organizations & group practices 3

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922147438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 S BOULDIN ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245022",
            "telephone_number": "214-888-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 S BOULDIN ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245022",
            "telephone_number": "214-888-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANOFSKI",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "T4766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.