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  7. NPI Record 1114978079

SAMUEL YOST MD
Complete NPI Record 1114978079
Surgery - Plastic and Reconstructive Surgery in Rochester, NY


Quality Rating: 97.8 out of 100 score

NPI Status: Active since May 15, 2006

Contact Information

1561 LONG POND RD STE 133
ROCHESTER, NY
ZIP 14626
Phone: (585) 723-7670
Fax: (585) 723-7671

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Credential Text
  6. Provider First Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider Business Mailing Address Fax Number
  13. Provider First Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Business Practice Location Address Fax Number
  20. Provider Enumeration Date
  21. Last Update Date
  22. Provider Gender Code
  23. Healthcare Provider Taxonomy Code 1
  24. Provider License Number 1
  25. Provider License Number State Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Healthcare Provider Taxonomy Code 2
  28. Provider License Number 2
  29. Provider License Number State Code 2
  30. Healthcare Provider Primary Taxonomy Switch 2
  31. Healthcare Provider Taxonomy Code 3
  32. Provider License Number 3
  33. Provider License Number State Code 3
  34. Healthcare Provider Primary Taxonomy Switch 3
  35. Other Provider Identifier 1
  36. Other Provider Identifier Type Code 1
  37. Other Provider Identifier State 1
  38. Other Provider Identifier Issuer 1
  39. Other Provider Identifier 2
  40. Other Provider Identifier Type Code 2
  41. Other Provider Identifier State 2
  42. Other Provider Identifier Issuer 2
  43. Other Provider Identifier 3
  44. Other Provider Identifier Type Code 3
  45. Other Provider Identifier State 3
  46. Other Provider Identifier Issuer 3
  47. Other Provider Identifier 4
  48. Other Provider Identifier Type Code 4
  49. Other Provider Identifier State 4
  50. Other Provider Identifier Issuer 4
  51. Other Provider Identifier 5
  52. Other Provider Identifier Type Code 5
  53. Other Provider Identifier State 5
  54. Other Provider Identifier 6
  55. Other Provider Identifier Type Code 6
  56. Other Provider Identifier State 6
  57. Other Provider Identifier Issuer 6
  58. Other Provider Identifier 7
  59. Other Provider Identifier Type Code 7
  60. Other Provider Identifier State 7
  61. Other Provider Identifier Issuer 7
  62. Other Provider Identifier 8
  63. Other Provider Identifier Type Code 8
  64. Other Provider Identifier State 8
  65. Other Provider Identifier Issuer 8
  66. Other Provider Identifier 9
  67. Other Provider Identifier Type Code 9
  68. Other Provider Identifier State 9
  69. Other Provider Identifier Issuer 9
  70. Other Provider Identifier 10
  71. Other Provider Identifier Type Code 10
  72. Other Provider Identifier State 10
  73. Other Provider Identifier Issuer 10
  74. Is Sole Proprietor
  75. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1114978079. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1114978079
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
The code designating the provider’s gender if the provider is a person.
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider First Name: SAMUEL
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Credential Text: MD
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider First Line Business Mailing Address: 100 KINGS HWY S
Provider Business Mailing Address City Name: ROCHESTER
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Provider Business Mailing Address State Name: NY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 146175504
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 5859223395
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 5859225114
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 1561 LONG POND RD STE 133
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: ROCHESTER
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NY
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 146264136
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 5857237670
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 5857237671
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 5/15/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 4/26/2021
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 207Q00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: MD061848L
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: PA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 207Q00000X
Provider License Number 2: 302495
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: NY
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: N
Healthcare Provider Taxonomy Code 3: 2086S0122X
Provider License Number 3: 302495
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 3: NY
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 3: Y
Other Provider Identifier 1: 70823
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: PA
Other Provider Identifier Issuer 1: GEISINGER HEALTH PLAN
Other Provider Identifier 2: 1522422
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: PA
Other Provider Identifier Issuer 2: GATEWAY-WMG
Other Provider Identifier 3: 210881
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: PA
Other Provider Identifier Issuer 3: JOHNS HOPKINS
Other Provider Identifier 4: 000472476
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4: PA
Other Provider Identifier Issuer 4: HIGHMARK B S
Other Provider Identifier 5: 001746737
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 5: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5: PA
Other Provider Identifier 6: 50078672
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 6: PA
Other Provider Identifier Issuer 6: CAPITAL BLUE CROSS
Other Provider Identifier 7: 7989829
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 7: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 7: PA
Other Provider Identifier Issuer 7: AETNA
Other Provider Identifier 8: 20076070
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 8: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 8: PA
Other Provider Identifier Issuer 8: AMERIHEALTH MERCY-WMG
Other Provider Identifier 9: 242173
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 9: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 9: PA
Other Provider Identifier Issuer 9: UNISON-WMG
Other Provider Identifier 10: 934613
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 10: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 10: MD
Other Provider Identifier Issuer 10: CAREFIRST MD BCBS
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date: 4/26/2021