Active NPI
Thomas Richard Yedica, SAC-IT
- Counselor
- Sheboygan, WI
National Provider Identifier
1922978360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 20848-130
- Practice address
- 505 Park Ave
Sheboygan, WI 53081-2871 - Phone
- (920) 803-8039
- NPI assigned
- Nov 10, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 20848-130 | WI | Primary |
Addresses
Primary practice location
505 Park Ave
Sheboygan, WI 53081-2871
Mailing address
505 Park Ave
Sheboygan, WI 53081-2871
Phone (920) 803-8039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20848-130 | WI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762732800000",
"number": "1922978360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 PARK AVE",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530812871",
"telephone_number": "920-803-8039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 PARK AVE",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530812871",
"telephone_number": "920-803-8039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEDICA",
"first_name": "THOMAS",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "SAC-IT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-10",
"last_updated": "2025-11-10",
"certification_date": "2025-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WI",
"license": "20848-130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.