| Mark K Yamaguchi, MD | |
|
155 Radio Dr, Woodbury, MN 55125-2619 | |
| (952) 831-8742 | |
| (952) 977-3459 |
| Full Name | Mark K Yamaguchi |
|---|---|
| Gender | Male |
| Speciality | Interventional Pain Management |
| Experience | 23 Years |
| Location | 155 Radio Dr, Woodbury, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033313580 | NPI | - | NPPES |
| 1033313580 | Medicaid | WI | |
| 000000614543 | Other | IN | ANTHEM PROVIDER NUMBER |
| 1033313580 | Medicaid | MN | |
| 200863980 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207LP2900X | Anesthesiology - Pain Medicine | 52910 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hudson Hospital | Hudson, WI | Hospital |
| Amery Hospital & Clinic | Amery, WI | Hospital |
| Westfields Hospital And Clinic | New richmond, WI | Hospital |
| Regions Hospital | Saint paul, MN | Hospital |
| Lakeview Memorial Hospital | Stillwater, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tria Orthopaedic Center Llc | 3173570561 | 511 |
| Group Health Plan Inc | 1759293954 | 1637 |
| Tria Orthopaedic Center Llc | 3173570561 | 511 |
| Entity Name | Group Health Plan Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710924683 PECOS PAC ID: 1759293954 Enrollment ID: O20031105000417 |
| Entity Name | Fairview Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461 |
| Entity Name | Tria Orthopaedic Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518273085 PECOS PAC ID: 3173570561 Enrollment ID: O20110310000999 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark K Yamaguchi, MD 8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516 Ph: () - | Mark K Yamaguchi, MD 155 Radio Dr, Woodbury, MN 55125-2619 Ph: (952) 831-8742 |