Individual provider Active NPI

Yassine Kanaan, M.D.

  • Pediatric Radiology Physician
  • Dallas, TX
National Provider Identifier
1285758219
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
P2132 Issued in TX
Practice address
2222 Welborn St
Dallas, TX 75219-3924
Phone
(214) 559-5000
Fax
(214) 443-7309
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X P2132 TX Primary

Addresses

Primary practice location

2222 Welborn St
Dallas, TX 75219-3924

Mailing address

2222 Welborn St
Dallas, TX 75219-3924
Phone (214) 559-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140604001363 TX Practitioner - Diagnostic Radiology 8325217854 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St LukesGroup PAC ID 6406764927, 164 clinicians

Practice addresses (Care Compare)

930 E 15TH St
Apt 528
Plano, TX 75074-5876
Phone (605) 622-5540

Hospital & facility affiliations

  • Avera St Lukes Hospital, Aberdeen, SD, CCN 430014
  • Milbank Area Hospital/Avera Health Hospital, Milbank, SD, CCN 431326
  • Community Memorial Hospital Hospital, Redfield, SD, CCN 431316
  • Mobridge Regional Hospital - Cah Hospital, Mobridge, SD, CCN 431325
  • Marshall County Healthcare Center - Cah Hospital, Britton, SD, CCN 431312

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Scottish Rite Hospital for Crippled Children Pediatric Radiology CurrentSince Feb 11, 2014 Accepting new patients
Avera St. Lukes CurrentSince Mar 1, 2023 Accepting new patients
Avera St. Luke'S CurrentSince Mar 1, 2023 Accepting new patients
Texas Radiology Associates LLP CurrentSince May 1, 2021 Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

3535 S Interstate 35 E
Denton, TX 76210
Phone (940) 384-3013

3800 Gaylord Pkwy
Ste 850
Frisco, TX 75034
Phone (469) 857-2222

5700 Dallas Pkwy
Frisco, TX 75034
Phone (469) 515-7100

401 W Campbell Rd
Richardson, TX 75080
Phone (940) 384-3535

Organizations & group practices 4

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 9

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1285758219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAAN",
        "first_name": "YASSINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "P2132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.