NPIMap

Individual provider Active NPI

Fadi Yacoub, MD

  • Internal Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1285690412
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31164 Issued in IA
Practice address
543 7TH St SE
Cedar Rapids, IA 52401-1929
Phone
(319) 369-4505
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31164 IA Primary

Addresses

Primary practice location

543 7TH St SE
Cedar Rapids, IA 52401-1929

Mailing address

PO Box 1824
Cedar Rapids, IA 52406-1824
Phone (319) 369-4505

Other identifiers 1

IdentifierTypeStateIssuer
5159087MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060608000034 IA Practitioner - NephrologyPractitioner - Internal Medicine 6800808932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Physician Associates IncGroup PAC ID 1355242496, 103 clinicians
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

1790 Blairs Ferry Rd
Hiawatha, IA 52233-2033
Phone (319) 378-8362

300 W May St
Marengo, IA 52301-1261
Phone (319) 642-5543

402 Siegel St
Tama, IA 52339-2302
Phone (641) 484-3333

502 N 9TH Ave
Vinton, IA 52349-2254
Phone (319) 472-6200

5264 Council St NE
Cedar Rapids, IA 52402-2477

701 10TH St SE
Cedar Rapids, IA 52403-1251
Phone (319) 221-8991

701 10TH St SE
Cedar Rapids, IA 52403-1292

701 10TH St SE J Edward Lundy
Mercy Pediatric Clinic
Cedar Rapids, IA 52403-1251
Phone (319) 832-2328

788 8TH Ave SE
204 Mercy Employee Health Center
Cedard Rapids, IA 52401-2107
Phone (319) 398-6342

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31164IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Associates, Inc Current Accepting new patients
Mercy Medical Center Current Accepting new patients
Mercy Medical Center CurrentSince Apr 22, 2021 Accepting new patients
Mercy Physician Associates, Inc CurrentSince May 1, 2006 Accepting new patients
Mercy Medical Center CurrentSince Apr 22, 2021 Accepting new patients
Mercy Physician Associates Inc CurrentSince May 1, 2006 Accepting new patients
Mercy Physician Associates, Inc Past Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

543 7th St SE
Cedar Rapids, IA 52401
Phone (319) 861-7600

5264 Council St NE
Ste 100
Cedar Rapids, IA 52402
Phone (319) 221-8444

1790 Blairs Ferry Rd
Hiawatha, IA 52233
Phone (319) 378-8362

300 W May St
Marengo, IA 52301
Phone (319) 462-8011

402 Siegel St
Tama, IA 52339
Phone (641) 484-3333

502 N 9th Ave
Vinton, IA 52349
Phone (319) 472-6200

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1285690412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524061824",
            "telephone_number": "319-369-4505",
            "fax_number": "319-369-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 7TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524011929",
            "telephone_number": "319-369-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "FADI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "31164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5159087",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.