Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Yury Fomin, MD

Individual provider Internal Medicine Physician · NPI 1003494683

Yury Fomin, MD is an Internal Medicine in Mesa, Arizona. Qualified in 2021, 5 years ago. Practices with Banner Hospital Based Physicians Arizona LLC, a 641-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
5
Licensed in
AZ
In the registry since
2021
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1400 S Dobson Rd
Mesa, AZ 85202
Phone: (480) 412-6788
Fax: (480) 412-6848
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence 77312 (AZ)
Internal Medicine Physician Taxonomy 207R00000X · Licence 77312 (AZ)
Pediatrics Physician Taxonomy 208000000X · Licence 77312 (AZ)

Record details

NPI number1003494683
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 1, 2021
Last updated in NPPESOctober 15, 2025
Certification dateOctober 15, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesHOSPITALIST
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Banner Hospital Based Physicians Arizona Llc — 641 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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