Organization Active NPI

Hesyra Medical Associates LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Laurel, MD
National Provider Identifier
1093955239
Registry record updated Feb 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
HESYRA MEDICAL ASSOCIATES LLC
Practice address
7300 Van Dusen Rd
Laurel Regional Hospital
Laurel, MD 20707-9463
Phone
(301) 497-7900
NPI assigned
Feb 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2009

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

Authorized official

Name
Dr. Mina M Yacoub, M.D.NPI 1073519823
Title
President
Phone
(703) 960-8150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X Primary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X

Addresses

Primary practice location

7300 Van Dusen Rd
Laurel Regional Hospital
Laurel, MD 20707-9463

Mailing address

8904 Garden Gate Dr
Attn: Dr M Yacoub
Fairfax, VA 22031-1471
Phone (703) 960-8150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090514000377 DC Part B Supplier - Clinic/Group Practice 2860541216 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, DC; Lanham, MD
O20230214000124 VA Part B Supplier - Clinic/Group Practice 2860541216 Receives reassigned benefits from 1 practitioner
Practice locations: Fredericksburg, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235779200000",
    "number": "1093955239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8904 GARDEN GATE DR",
            "address_2": "ATTN: DR M YACOUB",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311471",
            "telephone_number": "703-960-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 VAN DUSEN RD",
            "address_2": "LAUREL REGIONAL HOSPITAL",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207079463",
            "telephone_number": "301-497-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HESYRA MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-28",
        "last_updated": "2009-02-28",
        "status": "A",
        "authorized_official_last_name": "YACOUB",
        "authorized_official_first_name": "MINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-960-8150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.