YARMOUTH MEDICAL CENTER LLC – Family Medicine Physician, NPI 1124304456
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for YARMOUTH MEDICAL CENTER LLC
23 WHITES PATH
SUITE F
SOUTH YARMOUTH, MA 026641221
Phone: (508) 760-2054
Fax: (508) 760-1218
Type: Mailing
10 LITTLE BROOK RD
WEST WAREHAM, MA 025761222
Phone: (800) 841-5200
Fax: (508) 273-1241
Type: Mailing
21 AARONS WAY UNIT 2
WEST YARMOUTH, MA 026732596
Phone: (508) 760-2054
Fax: (508) 760-1218
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-04-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-07-31 (51 days away).
Enrollment records
1
Earliest due date
2026-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20120405000009 | O | Clinic/Group Practice | MA | 2026-07-31 |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02664)
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