1. Home
  2. Directory
  3. Illinois
  4. Urbana
  5. Surgery
  6. NPI Profile

DR. AMY KIM YETASOOK M.D.
NPI 1982028130
Surgery in Urbana, IL

Active since February 07, 2014PECOS Enrolled
611 W PARK ST, GRADUATE MEDICAL EDUCATION DEPARTMENT, URBANA, IL 61801(217) 326-1293 Get Directions Write a Review

NPPES record last updated: February 7, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Amy Kim Yetasook M.d. NPPES

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

DR. AMY KIM YETASOOK M.D. (NPI 1982028130) is an individual surgery provider in Urbana, Illinois, licensed in Illinois (125063845) and active in the NPI registry since February 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1982028130
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameDR. AMY KIM YETASOOKCredential: M.D.
Location Address611 W PARK ST, GRADUATE MEDICAL EDUCATION DEPARTMENTUrbana, IL 61801-2500
Mailing Address2114 W Division St, #3Chicago, IL 60622-3035 · (213) 268-5421
Phone(217) 326-1293
Sole ProprietorNo
Enumeration DateFebruary 7, 2014
✔ NPI 1982028130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IL · 125063845
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
611 W PARK ST, Urbana, IL 61801
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Amy Kim Yetasook M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

2

Medicare enrollment records show Amy Yetasook reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

County Of Los Angeles Auditor Controller
1,679 mi
Clinic/Center
335 E AVENUE I
Lancaster, CA 93535
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: County Of Los Angeles
  • 435 clinicians in this Medicare group
NPI 1366453045 (661) 948-8581
Community Foundation Medical Group
1,712 mi
Orthopaedic Surgery
2151 HERNDON AVE STE 105
Fresno, CA 93611
  • Reassigned Medicare billing, California enrollment
  • 508 clinicians in this Medicare group
NPI 1376056721 (559) 256-5200

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 61801 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
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.

DR. UDAY BHASKAR KANAKADANDI MD
Internal Medicine (Interventional Cardiology)
611 W PARK ST, HVI
URBANA, IL 61801
Champaign County (217) 383-3110
DR. VIKAS DESAI MD
Urology
611 W PARK ST
URBANA, IL 61801
Champaign County (217) 383-3160
ANUJA BEDI D.O, M.P.H
Family Medicine
611 W PARK ST
URBANA, IL 61801
Champaign County (217) 383-3311
EMILY REMINGTON NP
Nurse Practitioner (Women's Health)
611 W PARK ST
URBANA, IL 61801
Champaign County (217) 383-3140
MAHMOUD ELRAKHAWY MD
Surgery (Vascular Surgery)
611 W PARK ST
URBANA, IL 61801
Champaign County (217) 904-7000
KENDALL E WALLACE APRN
Nurse Practitioner (Family)
611 W PARK ST
URBANA, IL 61801
Champaign County (217) 383-3311
ANNE FAHNESTOCK PT
Physical Therapist
611 W PARK ST
URBANA, IL 61801
Champaign County (217) 383-3311
TIMTIM APPERSON APRN
Family Medicine
611 W PARK ST
URBANA, IL 61801
Champaign County (217) 954-2805

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 Amy Yetasook's NPI number?

The NPI number for Amy Yetasook is 1982028130. It was assigned to this individual provider in the NPPES registry on February 7, 2014.

Where is Amy Yetasook located?

Amy Yetasook practices at 611 W Park St Graduate Medical Education Department, Urbana, IL 61801. The listed phone number is (217) 326-1293.

What is Amy Yetasook's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Amy Yetasook enrolled in Medicare?

Yes. Amy Yetasook is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Amy Yetasook's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amy Yetasook reassigns Medicare benefits to 2 organizations: County Of Los Angeles Auditor Controller (Lancaster, CA) and Community Foundation Medical Group (Fresno, CA). Each 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 Amy Yetasook'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 Amy Yetasook was last updated on February 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.