Individual provider Active NPI

Yssa Saaddine, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • East Point, GA
National Provider Identifier
1063476810
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
019991 Issued in GA
Practice address
1136 Cleveland Ave
Ste 209
East Point, GA 30344-3618
Phone
(404) 762-8211
Fax
(404) 762-9182
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 019991 GA Primary

Addresses

Primary practice location

1136 Cleveland Ave
Ste 209
East Point, GA 30344-3618

Mailing address

1136 Cleveland Ave
Ste 209
East Point, GA 30344-3618
Phone (404) 762-8211

Other identifiers 1

IdentifierTypeStateIssuer
00205191CMedicaidGA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
019991GAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: yssa.saaddine.p50@direct.tenet.nextgenshare.com
  • Direct secure messaging: ysaaddine125260@directwellstar.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1063476810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 CLEVELAND AVE",
            "address_2": "STE 209",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443618",
            "telephone_number": "404-762-8211",
            "fax_number": "404-762-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 CLEVELAND AVE",
            "address_2": "STE 209",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443618",
            "telephone_number": "404-762-8211",
            "fax_number": "404-762-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAADDINE",
        "first_name": "YSSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "019991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00205191C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.