Organization Active NPI

Yoo Foot and Ankle Podiatry, LLC.

  • Foot & Ankle Surgery Podiatrist
  • Dorchester, MA
National Provider Identifier
1952848103
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
YOO FOOT AND ANKLE PODIATRY, LLC.
Practice address
2110 Dorchester Ave Ste 203
Dorchester, MA 02124
Phone
(617) 696-5355
Fax
(617) 696-5357
NPI assigned
Jan 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Authorized official

Name
Ki-Hyuk Yoo, DPMNPI 1881906626
Title
DPM/Owner
Phone
(716) 536-2090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

2110 Dorchester Ave Ste 203
Dorchester, MA 02124

Mailing address

2110 Dorchester Ave Ste 203
Dorchester, MA 02124-5699
Phone (617) 696-5355

Other practice location 1

2100 Dorchester Ave
Dorchester, MA 02124-5615
Phone (617) 506-4905

Other identifiers 1

IdentifierTypeStateIssuer
110122599AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170505001279 MA Part B Supplier - Clinic/Group Practice 5395022065 Receives reassigned benefits from 1 practitioner
Practice locations: Dorchester, MA

National Provider Directory

National Provider Directory

Locations

50 Redfield St
Ste 301
Dorchester, MA 02122
Phone (617) 288-7450

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15451/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1952848103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 DORCHESTER AVE STE 203",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021245699",
            "telephone_number": "617-696-5355",
            "fax_number": "617-696-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 DORCHESTER AVE STE 203",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02124",
            "telephone_number": "617-696-5355",
            "fax_number": "617-696-5357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Dorchester Ave",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021245615",
            "country_code": "US",
            "telephone_number": "617-506-4905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "YOO FOOT AND ANKLE PODIATRY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-26",
        "last_updated": "2018-12-19",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "KI-HYUK",
        "authorized_official_title_or_position": "DPM/OWNER",
        "authorized_official_telephone_number": "716-536-2090",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110122599A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.