Active NPI
Shereef Kamal Yassin, MD
- Anesthesiology Physician
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 65455
- Practice address
- 9000 W Wisconsin Ave
Pediatric Anesthesiology
Milwaukee, WI 53226-4874 - Phone
- (414) 266-3560
- Fax
- (414) 266-6092
- NPI assigned
- Aug 8, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125.062440 | IL | |
| Anesthesiology Physician | 207L00000X | 65455 | WI | Primary |
Addresses
Primary practice location
9000 W Wisconsin Ave
Pediatric Anesthesiology
Milwaukee, WI 53226-4874
Mailing address
9000 W Wisconsin Ave
Pediatric Anesthesiology
Milwaukee, WI 53226-4874
Phone (414) 266-3560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184971202 | Medicaid | WI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | syassin111171@epicdirect.promedica.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1805 27TH St
Portsmouth, OH 45662-2640
Phone (740) 356-8681
2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000
Hospital & facility affiliations
- Promedica Toledo Hospital
- Southern Ohio Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.062440 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Somc Medical Care Foundation, Inc. | Anesthesiology | Current | Accepting new patients |
| Somc Medical Care Foundation, Inc. | Current | Accepting new patients | |
| Promedica Central Physicians | Current | Accepting new patients | |
| Somc Medical Care Foundation, Inc. | Current | Accepting new patients | |
| Promedica Central Physicians | Internal Medicine | Current | Accepting new patients |
Locations
1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000
2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111
2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112
1 Seagate
Ste 800
Toledo, OH 43604
100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Portsmouth, OH
- NPI 1457467227
-
- Durable Medical Equipment & Medical Supplies
- Toledo, OH
- NPI 1669068482
-
- Diagnostic Radiology Physician
- Portsmouth, OH
- NPI 1366686230
-
- Anesthesiology Physician
- Portsmouth, OH
- NPI 1629247010
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portsmouth, OH
- NPI 1053342816
-
- General Acute Care Hospital
- Toledo, OH
- NPI 1407854771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1184971202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"address_2": "PEDIATRIC ANESTHESIOLOGY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-266-3560",
"fax_number": "414-266-6092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"address_2": "PEDIATRIC ANESTHESIOLOGY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-266-3560",
"fax_number": "414-266-6092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YASSIN",
"first_name": "SHEREEF",
"middle_name": "KAMAL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-08",
"last_updated": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125.062440",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "65455",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1184971202",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "syassin111171@epicdirect.promedica.org",
"affiliation": "N",
"address_1": "100 Madison Ave",
"city": "Toledo",
"state": "OH",
"country_code": "US",
"postal_code": "436041516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.