Brad A Yentzer, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

287410 Issued in NY

Practice address

2141 Dryden Rd
Freeville, NY 13068-9611

Phone

(607) 708-1330

Fax

(607) 708-4242

NPI assigned

Apr 28, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Dermatology

Education

Jefferson Medical College of Thomas Jefferson University, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Finger Lakes Dermatology, PLLCGroup PAC ID 4486088986, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307
• Guthrie Cortland Regional Medical Center Hospital, Cortland, NY, CCN 330175

Merit-based Incentive Payment System (MIPS)

Final score

70.21 of 100Reported as individual

Quality

57.84

Promoting interoperability

78

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Finger Lakes Dermatology PLLC

  • Dermatology Physician
  • Freeville, NY
  • NPI 1508402710
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cayuga Medical Center at Ithaca

  • General Acute Care Hospital
  • Ithaca, NY
  • NPI 1962422733
  Care Compare affiliation
• Guthrie Cortland Medical Center

  • General Acute Care Hospital
  • Cortland, NY
  • NPI 1740287531
  Care Compare affiliation

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1962677138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 DRYDEN RD",
            "city": "FREEVILLE",
            "state": "NY",
            "postal_code": "130689611",
            "telephone_number": "607-708-1330",
            "fax_number": "607-708-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 DRYDEN RD",
            "city": "FREEVILLE",
            "state": "NY",
            "postal_code": "130689611",
            "telephone_number": "607-708-1330",
            "fax_number": "607-708-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YENTZER",
        "first_name": "BRAD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "287410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Jo Webb, LPN
• Richard Weiner, PT
• Jens L. Wennberg, PA
• William George Agency
• Susan R Yanoff, D.V.M.
• Alexandra Zieba, PT

• Dermatology Physician in Freeville, NY
• Providers in Freeville, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.

Verify at the official NPI Registry.