Individual provider Active NPI

Yaroslav Dvorskyy, M.D

  • Family Medicine Physician
  • Wilkes Barre, PA
National Provider Identifier
1992950604
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MT201932 Issued in PA
Practice address
101 Indian Creek Dr
Wilkes Barre, PA 18702-7824
Phone
(570) 855-2086
NPI assigned
Nov 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT201932 PA Primary

Addresses

Primary practice location

101 Indian Creek Dr
Wilkes Barre, PA 18702-7824

Mailing address

101 Indian Creek Dr
Wilkes Barre, PA 18702-7824
Phone (570) 855-2086

Other identifiers 1

IdentifierTypeStateIssuer
MT201932OtherPAWRIGHT CENTER POSTGRADUATE TRAINING

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1992950604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 INDIAN CREEK DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027824",
            "telephone_number": "570-855-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 INDIAN CREEK DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027824",
            "telephone_number": "570-855-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORSKYY",
        "first_name": "YAROSLAV",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-21",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT201932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WRIGHT CENTER POSTGRADUATE TRAINING",
            "identifier": "MT201932",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.