Individual provider Active NPI

Shereef Kamal Yassin, MD

  • Anesthesiology Physician
  • Milwaukee, WI
National Provider Identifier
1184971202
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
65455 Issued in WI
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

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1184971202MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171002003775 OH Practitioner - Anesthesiology 1153618954 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somc Medical Care Foundation, Inc.Group PAC ID 9436061645, 388 clinicians
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

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 Hospital, Toledo, OH, CCN 360068
  • Southern Ohio Medical Center Hospital, Portsmouth, OH, CCN 360008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.062440ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Somc Medical Care Foundation, Inc. Anesthesiology CurrentSince Dec 19, 2025 Accepting new patients
Somc Medical Care Foundation, Inc. CurrentSince Dec 19, 2025 Accepting new patients
Promedica Central Physicians CurrentSince Sep 1, 2017 Accepting new patients
Somc Medical Care Foundation, Inc. Current Accepting new patients
Promedica Central Physicians Internal Medicine CurrentSince Sep 1, 2017 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.

Hospital & facility affiliations 3

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": "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

Verify at the official NPI Registry.