Active NPI
Yasseen Kuzbary, MD
- Diagnostic Radiology Physician
- Camden, SC
National Provider Identifier
1073683587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 13202
- Practice address
- Haile and Roberts Streets
Camden, SC 29020 - Phone
- (803) 713-6196
- NPI assigned
- Nov 9, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 13202 | SC | Primary |
Addresses
Primary practice location
Haile and Roberts Streets
Camden, SC 29020
Mailing address
PO Box 2769
Orangeburg, SC 29116-2769
Phone (803) 534-0053
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 132029 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13202 | SC | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Diagnostic Imaging Center, LLC | Diagnostic Radiology | 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.
-
- Diagnostic Radiology Physician
- Orangeburg, SC
- NPI 1164591756
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073683587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2769",
"city": "ORANGEBURG",
"state": "SC",
"postal_code": "291162769",
"telephone_number": "803-534-0053",
"fax_number": "803-536-1198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HAILE AND ROBERTS STREETS",
"city": "CAMDEN",
"state": "SC",
"postal_code": "29020",
"telephone_number": "803-713-6196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUZBARY",
"first_name": "YASSEEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "SC",
"license": "13202",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "132029",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Camden, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.