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YURY FOMIN MD
NPI 1003494683
Hospitalist in Mesa, AZ

Active since April 01, 2021PECOS EnrolledAccepts Medicare Assignment
1400 S DOBSON ROAD, MESA, AZ 85202(480) 412-6788(480) 412-6848 Get Directions Write a Review

NPPES record last updated: October 15, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Yury Fomin Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YURY FOMIN MD (NPI 1003494683) is an individual hospitalist provider in Mesa, Arizona, licensed in Arizona (77312) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1003494683
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameYURY FOMINCredential: MD
Location Address1400 S DOBSON ROADMesa, AZ 85202
Mailing Address1400 S Dobson Road, Attn Bmg Hospitalist Team/amanda GumpMesa, AZ 85202 · (480) 412-6788 · Fax (480) 412-6848
Phone(480) 412-6788
Fax(480) 412-6848
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateApril 1, 2021
Last NPPES UpdateOctober 15, 2025
NPPES CertifiedOctober 15, 2025
✔ NPI 1003494683 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in AZ · 77312
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 77312 (AZ)
Also ListedPediatricsTaxonomy 208000000X · License 77312 (AZ)
1400 S DOBSON ROAD, Mesa, AZ 85202
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Yury Fomin Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436540218
PECOS Enrollment IDI20250812002730
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Yury Fomin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Banner Hospital Based Physicians Arizona LLC
8.8 mi
Multi-Specialty
1900 N HIGLEY RD
Gilbert, AZ 85234
  • Reassigned Medicare billing, Arizona enrollment
  • 1,081 clinicians in this Medicare group
NPI 1124374822 (480) 543-2034

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOUHSEN H ALHAKEEM MD
Internal Medicine (Critical Care Medicine)
1400 S DOBSON ROAD, ATTN AMANDA GUMP/HOSPITALIST
MESA, AZ 85202
Maricopa County (480) 412-6788
MR. ERIC DONG D.O.
Hospitalist
1400 S DOBSON ROAD
MESA, AZ 85202
Maricopa County (480) 412-6788
MR. SAI PRASHANTH HARANATH M.D.
Internal Medicine
1400 S DOBSON ROAD, ATTN AMANDA GUMP/ HOSPITALISTS
MESA, AZ 85202
Maricopa County (480) 543-2034
RADHA KRISHNA KOTHAPALLI MD
Hospitalist
1400 S DOBSON ROAD, ATTN BMG HOSPITALIST TEAM/AMANDA GUMP
MESA, AZ 85202
Maricopa County (480) 412-6788
DR. TRACY ERIN MCNAMARA DO
Hospitalist
1400 S DOBSON ROAD
MESA, AZ 85202
Maricopa County (480) 412-6788
AARON EMBDEN FLEGENHEIMER MD
Internal Medicine
1400 S DOBSON ROAD
MESA, AZ 85202
Maricopa County (480) 412-6788
SLAVKO ALEKSIS DO
Internal Medicine
1400 S DOBSON ROAD
MESA, AZ 85202
Maricopa County (480) 412-6788
DR. SRIKANT KUMAR MD
Hospitalist
1400 S DOBSON ROAD
MESA, AZ 85202
Maricopa County (480) 412-6788

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Yury Fomin's NPI number?

The NPI number for Yury Fomin is 1003494683. It was assigned to this individual provider in the NPPES registry on April 1, 2021.

Where is Yury Fomin located?

Yury Fomin practices at 1400 S Dobson Road, Mesa, AZ 85202. The listed phone number is (480) 412-6788.

What is Yury Fomin's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Yury Fomin enrolled in Medicare?

Yes. Yury Fomin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Yury Fomin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Yury Fomin reassigns Medicare benefits to Banner Hospital Based Physicians Arizona LLC (Gilbert, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Yury Fomin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Yury Fomin was last updated on October 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.