| Nicole Faye Yeshtokin, DO | |
|
22232 Wilborn Ave Ste C, South Boston, VA 24592-1662 | |
| (434) 517-3910 | |
| (434) 517-3912 |
| Full Name | Nicole Faye Yeshtokin |
|---|---|
| Gender | Female |
| Speciality | General Surgery |
| Experience | 16 Years |
| Location | 22232 Wilborn Ave Ste C, South Boston, Virginia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336371525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 2020-04156 (North Carolina) | Secondary |
| 208600000X | Surgery | 0T013281 (Pennsylvania) | Secondary |
| 208600000X | Surgery | 0102203996 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bon Secours Maryview Medical Center | Portsmouth, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bon Secours Medical Group Hampton Roads Specialty Care Llc | 3173955671 | 159 |
| Entity Name | Mary Immaculate Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538535463 PECOS PAC ID: 0042124042 Enrollment ID: O20031114000096 |
| Entity Name | Sentara Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265485270 PECOS PAC ID: 8921903923 Enrollment ID: O20031203000466 |
| Entity Name | Dominion Health Medical Assoc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255771770 PECOS PAC ID: 1254311558 Enrollment ID: O20041206000840 |
| Entity Name | Bon Secours Medical Group Hampton Roads Specialty Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629637475 PECOS PAC ID: 3173955671 Enrollment ID: O20191122000258 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Faye Yeshtokin, DO 2232 Wilborn Ave Ste C, South Boston, VA 24592-1662 Ph: (434) 517-3910 | Nicole Faye Yeshtokin, DO 22232 Wilborn Ave Ste C, South Boston, VA 24592-1662 Ph: (434) 517-3910 |
Yaning Zhang, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2232 Wilborn Ave Ste C, South Boston, VA 24592 Phone: 434-517-3100 | |
William Allen Fuller Jr., MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 2212 Wilborn Ave, South Boston, VA 24592 Phone: 434-572-8921 Fax: 434-572-2063 | |
Gurnam S Bajwa, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 2206a Wilborn Ave, South Boston, VA 24592 Phone: 434-572-2744 Fax: 434-572-2785 | |
Lovetta Pugh, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2232 Wilborn Ave, South Boston, VA 24592 Phone: 434-572-8921 Fax: 434-572-2063 | |
Edward Sanford Purvis Ii, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 2232 Wilborn Avenue, Physicians Pavilion, South Boston, VA 24592 Phone: 434-517-0233 |