Individual provider Active NPI

Yasser A. Al-Antably, MD

  • Gastroenterology Physician
  • Sacramento, CA
National Provider Identifier
1285712992
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A65391 Issued in CA
Practice address
2025 Morse Ave
Sacramento, CA 95825-2115
Phone
(916) 973-5000
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A65391 CA Primary

Addresses

Primary practice location

2025 Morse Ave
Sacramento, CA 95825-2115

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3466
Phone (510) 625-6262

Other identifiers 1

IdentifierTypeStateIssuer
00A653910MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110217000944 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 4981885308 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A65391CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Apr 1, 2026 Accepting new patients
Adventist Health Physicians Network Gastroenterology CurrentSince Apr 1, 2026 Accepting new patients
Banner-University Medical Group Family Medicine Current Accepting new patients
Permanente Medical Group Inc Family Medicine Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 20, 2010 Accepting new patients
Permanente Medical Group Inc Family Medicine CurrentSince Oct 20, 2010 Accepting new patients
Adventist Health Heart Institute-Ukiah Past Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

1800 Harrison St
Fl 7
Oakland, CA 94612

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

6600 Bruceville Rd
Sacramento, CA 95823

2025 Morse Ave
Sacramento, CA 95825

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

35 Casa St
Ste 130
San Luis Obispo, CA 93405
Phone (805) 541-1422

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Interoperability endpoints

  • Direct secure messaging: yasser.al-antably.1@31068.direct.athenahealth.com

Organizations & group practices 9

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 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health Physicians Network 628 clinicians

Practice addresses (Care Compare)

1154 E Grand Ave
Arroyo Grande, CA 93420-2583
Phone (805) 395-3277

35 Casa St
Suite 130
San Luis Obispo, CA 93405-1887
Phone (805) 541-1422

Hospital & facility affiliations

  • Kaiser Foundation Hospital - San Diego Hospital, San Diego, CA, CCN 050515
  • Adventist Health Sierra Vista Hospital, San Luis Obispo, CA, CCN 050506

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux58

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1285712992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 MORSE AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252115",
            "telephone_number": "916-973-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-ANTABLY",
        "first_name": "YASSER",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A65391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A653910",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6600 Bruceville Rd",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958234671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.