Individual provider Active NPI

Sina Yaqub

  • Registered Nurse
  • Camden, NJ
National Provider Identifier
1053058479
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
649595 Issued in PA
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(800) 826-6737
NPI assigned
May 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 649595 PA Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Cooper PLZ
Camden, NJ 08103-1461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220815002203 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305229907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Federal St
Suite 200
Camden, NJ 08103-1005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.96 of 100Reported as group
Quality
73.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
649595PAMDRegistered Nurse

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1053058479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "800-826-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAQUB",
        "first_name": "SINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "649595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.