Individual provider Active NPI

Yahya Bakdalieh, MD

  • Physical Medicine & Rehabilitation Physician
  • Kalamazoo, MI
National Provider Identifier
1154416659
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
35.090651 Issued in OH
Practice address
3025 Gull Rd
Kalamazoo, MI 49048-1281
Phone
(269) 552-2225
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 35.090651 OH
Physical Medicine & Rehabilitation Physician 208100000X 4301075956 MI
Physical Medicine & Rehabilitation Physician 208100000X 35.090651 OH Primary

Addresses

Primary practice location

3025 Gull Rd
Kalamazoo, MI 49048-1281

Mailing address

6347 Sitka Spruce St
Portage, MI 49024-9031
Phone (269) 779-8985

Other identifiers 1

IdentifierTypeStateIssuer
200265770AMedicaidKS

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
I20120713000470 OH Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 2365411576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

2945 Maple Ave
Zanesville, OH 43701-1762
Phone (740) 454-4712

Hospital & facility affiliations

  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group LLC Pain Medicine Current Accepting new patients
Genesis Medical Group, LLC CurrentSince Jul 11, 2012 Accepting new patients
Genesis Medical Group, LLC CurrentSince Jul 11, 2012 Accepting new patients
Genesis Healthcare System Past Accepting new patients

Locations

646 Chestnut St
Coshocton, OH 43812
Phone (740) 622-3370

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

2945 Maple Ave
Zanesville, OH 43701
Phone (740) 454-0158

2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

1246 Ashland Ave
Ste 204
Zanesville, OH 43701
Phone (740) 450-6167

2945 Maple Ave
Ste 2B
Zanesville, OH 43701
Phone (740) 454-4712

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1154416659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6347 SITKA SPRUCE ST",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490249031",
            "telephone_number": "269-779-8985",
            "fax_number": "620-231-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481281",
            "telephone_number": "269-552-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKDALIEH",
        "first_name": "YAHYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "35.090651",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301075956",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "35.090651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200265770A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.