Individual provider Active NPI

Ghazaleh Yasmeh

  • Physician Assistant
  • Great Neck, NY
National Provider Identifier
1053576660
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20430 Issued in CA
Practice address
60 Knights Bridge Rd
Apt# 1D
Great Neck, NY 11021
Phone
(818) 445-1724
NPI assigned
Jul 23, 2008
Last updated
Nov 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 012522 NY
Physician Assistant 363A00000X PA20430 CA Primary

Addresses

Primary practice location

60 Knights Bridge Rd
Apt# 1D
Great Neck, NY 11021

Mailing address

60 Knights Bridge Rd
Apt# 1D
Great Neck, NY 11021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
012522NYMDClinical Psychologist
PA20430CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northridge Emergency Medical Group Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1053576660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 KNIGHTS BRIDGE RD",
            "address_2": "APT# 1D",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 KNIGHTS BRIDGE RD",
            "address_2": "APT# 1D",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021",
            "telephone_number": "818-445-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASMEH",
        "first_name": "GHAZALEH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012522",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.