Provider Demographics
NPI:1114978079
Name:YOST, SAMUEL (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:YOST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-3395
Mailing Address - Fax:585-922-5114
Practice Address - Street 1:1561 LONG POND RD STE 133
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4136
Practice Address - Country:US
Practice Address - Phone:585-723-7670
Practice Address - Fax:585-723-7671
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302495207Q00000X, 2086S0122X
PAMD061848L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000472476OtherHIGHMARK B S
PA210881OtherJOHNS HOPKINS
PA001746737Medicaid
PA1522422OtherGATEWAY-WMG
PA50078672OtherCAPITAL BLUE CROSS
PA7989829OtherAETNA
MD934613OtherCAREFIRST MD BCBS
PA20076070OtherAMERIHEALTH MERCY-WMG
PA242173OtherUNISON-WMG
PA70823OtherGEISINGER HEALTH PLAN
PA70823OtherGEISINGER HEALTH PLAN
PA001746737Medicaid
PA000472476OtherHIGHMARK B S
PA025892FLTMedicare PIN
PA240007165Medicare PIN