Individual provider Active NPI

Lyn E Yakubov, M.D.

  • Ophthalmology Physician
  • Poland, OH
National Provider Identifier
1144222746
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35-055476 Issued in OH
Practice address
1075 W Western Reserve Rd
Poland, OH 44514-3541
Phone
(330) 746-7691
NPI assigned
Aug 12, 2005
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35-055476 OH Primary

Addresses

Primary practice location

1075 W Western Reserve Rd
Poland, OH 44514-3541

Mailing address

10 Dutton Dr
Youngstown, OH 44502-1818
Phone (330) 746-7691

Other practice location 1

1031 W Western Reserve Rd
Poland, OH 44514-3541
Phone (330) 746-7691

Other practice location 2

10 Dutton Dr
Youngstown, OH 44502-1818
Phone (330) 746-7691

Other identifiers 9

IdentifierTypeStateIssuer
0015728340004OtherPAMEDICAID
0800740OtherOHUNITED HEALTHCARE
4512389OtherOHAETNA
000000126328OtherOHANTHEM
178994OtherOHKEYSTONE
180023970OtherOHRAILROAD MEDICARE
Z55476OtherOHSUMMACARE
82800OtherOHQUALCHOICE
0672731MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091211000399 OH Practitioner - Ophthalmology 5890749154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Northeastern Ohio University College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates, IncGroup PAC ID 0042350118, 14 clinicians

Practice addresses (Care Compare)

10 Dutton Dr
Youngstown, OH 44502-1818
Phone (330) 884-6584

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.55 of 100Reported as group
Quality
93.28
Promoting interoperability
100
Improvement activities
40
Cost
48.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-055476OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates, Inc Ophthalmology CurrentSince May 27, 2015 Accepting new patients
Eye Care Associates, Inc Ophthalmology CurrentSince May 27, 2015 Accepting new patients
Eye Care Associates, Inc Ophthalmology Current Accepting new patients
Center for Advanced Eye Surgery, LTD CurrentSince Jan 1, 2023 Accepting new patients

Locations

15655 State Route 170
Ste O
East Liverpool, OH 43920
Phone (330) 746-7691

1075 W Western Reserve Rd
Poland, OH 44514
Phone (330) 746-7691

4060 N River Rd NE
Warren, OH 44484
Phone (330) 746-7691

10 Dutton Dr
Youngstown, OH 44502
Phone (330) 746-7691

1031 W Western Reserve Rd
Youngstown, OH 44514
Phone (330) 746-7691

3155 Canfield Rd
Youngstown, OH 44511
Phone (330) 746-7691

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: lyakubov@ecaoh.intellechartdirect.net
  • Direct secure messaging: lyakubov34579@direct.bsmhealth.org
  • Direct secure messaging: lyn.yakubov.p1@direct.eyecare.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1144222746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DUTTON DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445021818",
            "telephone_number": "330-746-7691",
            "fax_number": "330-743-8368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 W WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143541",
            "telephone_number": "330-746-7691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1031 W Western Reserve Rd",
            "address_purpose": "LOCATION",
            "city": "Poland",
            "state": "OH",
            "postal_code": "445143541",
            "country_code": "US",
            "telephone_number": "330-746-7691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Dutton Dr",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445021818",
            "country_code": "US",
            "telephone_number": "330-746-7691",
            "fax_number": "330-743-8368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAKUBOV",
        "first_name": "LYN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35-055476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "0015728340004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0800740",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4512389",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000126328",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "178994",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180023970",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE",
            "identifier": "Z55476",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "82800",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0672731",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.