Individual provider Active NPI

Nabil M Yazgi, MD, PA

  • Specialist
  • Wayne, NJ
National Provider Identifier
1144337908
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA4538400 Issued in NJ
Practice address
401 Hamburg Tpke Ste 102
Wayne, NJ 07470-2139
Phone
(973) 790-1180
Fax
(973) 790-0712
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA4538400 NJ Primary

Addresses

Primary practice location

401 Hamburg Tpke Ste 102
Wayne, NJ 07470-2139

Mailing address

401 Hamburg Tpke Ste 102
Wayne, NJ 07470-2139
Phone (973) 790-1180

Other identifiers 1

IdentifierTypeStateIssuer
3983307MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20081006000104 NJ Practitioner - Neurology 1052498813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

401 Hamburg Turnpike
Suite 102
Wayne, NJ 07470-2139
Phone (973) 790-1180

Hospital & facility affiliations

  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019
  • Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA4538400NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Nabil M Yazgi, M.D. P.a. Specialist CurrentSince May 11, 2011 Accepting new patients
North Jersey Center for Surgery PA PastSince Apr 30, 2003 Accepting new patients
Wayne Physical Therapy LLC Past Accepting new patients

Locations

401 Hamburg Tpke
Ste 102
Wayne, NJ 07470
Phone (201) 794-2121

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288310400000",
    "number": "1144337908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HAMBURG TPKE STE 102",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702139",
            "telephone_number": "973-790-1180",
            "fax_number": "973-790-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HAMBURG TPKE STE 102",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702139",
            "telephone_number": "973-790-1180",
            "fax_number": "973-790-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAZGI",
        "first_name": "NABIL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA4538400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3983307",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.