Organization Active NPI

Joseph Yacisen, DO, PC

  • Specialist
  • Saginaw, MI
National Provider Identifier
1184167595
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
JY012516 Issued in MI
Legal business name
JOSEPH YACISEN, DO, PC
Practice address
2130 Marshall CT
Saginaw, MI 48602-3351
Phone
(989) 466-2663
Fax
(989) 466-4748
NPI assigned
Dec 2, 2016
Last updated
Dec 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2016

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

Authorized official

Name
Mrs. Cheryl Ann Pope
Title
Biller
Phone
(989) 466-2663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X JY012516 MI Primary

Addresses

Primary practice location

2130 Marshall CT
Saginaw, MI 48602-3351

Mailing address

2130 Marshall CT
Saginaw, MI 48602-3351
Phone (989) 466-2663

Other identifiers 1

IdentifierTypeStateIssuer
114926111MedicaidMI

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480636800000",
    "number": "1184167595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 MARSHALL CT",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023351",
            "telephone_number": "989-466-2663",
            "fax_number": "989-466-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MARSHALL CT",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023351",
            "telephone_number": "989-466-2663",
            "fax_number": "989-466-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH YACISEN, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-02",
        "last_updated": "2016-12-02",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "989-466-2663",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "JY012516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114926111",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.