Individual provider Active NPI

Shaden Hamdy Fathy Yassin, MD

  • Retina Specialist (Ophthalmology) Physician
  • Lexington, KY
National Provider Identifier
1033007570
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
FL084 Issued in KY
Practice address
110 Conn Ter Ste 550
Lexington, KY 40508-3206
Phone
(859) 323-5867
Fax
(859) 323-8510
NPI assigned
Jun 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X FL084 KY
Retina Specialist (Ophthalmology) Physician 207WX0107X FL084 KY Primary

Addresses

Primary practice location

110 Conn Ter Ste 550
Lexington, KY 40508-3206

Mailing address

110 Conn Ter Ste 550
Lexington, KY 40508-3206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250920000077 KY Practitioner - Ophthalmology 3870097934 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

110 Conn Ter
Suite 550
Lexington, KY 40508-3206
Phone (859) 323-5867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Sep 9, 2025 Accepting new patients
Kentucky Medical Services Foundation, Inc Ophthalmology CurrentSince Sep 9, 2025 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1033007570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CONN TER STE 550",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405083206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CONN TER STE 550",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405083206",
            "telephone_number": "859-323-5867",
            "fax_number": "859-323-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASSIN",
        "first_name": "SHADEN",
        "middle_name": "HAMDY FATHY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "FL084",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "KY",
            "license": "FL084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.