Individual provider Active NPI

Maryam M. Yassa, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Plainsboro, NJ
National Provider Identifier
1184042277
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1 Plainsboro Rd Dept of
Plainsboro, NJ 08536-1913
Phone
(609) 853-7000
NPI assigned
Apr 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 25MA11625300 NJ
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1 Plainsboro Rd Dept of
Plainsboro, NJ 08536-1913

Mailing address

1 Plainsboro Rd Dept of
Plainsboro, NJ 08536-1913
Phone (609) 853-7000

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
I20250828001141 NJ Practitioner - Preventive Medicine 6305347717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5 Plainsboro Rd
Plainsboro, NJ 08536-1915

993 Lenox Dr
Suite 207
Lawrenceville, NJ 08648-2389

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11625300NJMDPreventive Medicine/Occupational Environmental Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Jul 1, 2025 Accepting new patients
Princeton Healthcare Affiliated Physicians PC Current Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Jul 1, 2025 Accepting new patients

Locations

401 Ridge Rd
Ste 6
Dayton, NJ 08810
Phone (732) 329-4800

1 Plainsboro Rd
Plainsboro, NJ 08536
Phone (609) 853-7000

5 Plainsboro Rd
Ste 570
Plainsboro, NJ 08536
Phone (609) 853-7474

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.

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1184042277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PLAINSBORO RD DEPT OF",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361913",
            "telephone_number": "609-853-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PLAINSBORO RD DEPT OF",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361913",
            "telephone_number": "609-853-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASSA",
        "first_name": "MARYAM",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NJ",
            "license": "25MA11625300",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainsboro, NJ

Sources for this page

Verify at the official NPI Registry.