Ehab S Yacoub, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A76244 Issued in CA

Practice address

18546 Roscoe Blvd
Suite 210
Northridge, CA 91324-4663

Phone

(818) 886-5628

Fax

(818) 701-8042

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, AZ, FL, CO, TX5 enrollments

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 5

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (6 of 7)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ehab.yacoub.p1@direct.scfhc.nextgenshare.com

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.

• Brain Health USA Inc

  • Child & Adolescent Psychiatry Physician
  • Van Nuys, CA
  • NPI 1316792799

  CA, Child & Adolescent Psychiatry

  Medicare reassignment NPD Authorized official
• Ehab Yacoub MD Inc.

  • Child & Adolescent Psychiatry Physician
  • Gardena, CA
  • NPI 1417373713

  AZ, CA, Child & Adolescent Psychiatry, CO, FL, TX

  Medicare reassignment NPD Authorized official
• Ehab Yacoub MD PLLC

  • Psychiatry Physician
  • Fort Worth, TX
  • NPI 1700685997

  Psychiatry, TX

  Medicare reassignment NPD Authorized official
• Brain Health USA Inc

  • Psychiatry Physician
  • Van Nuys, CA
  • NPI 1649138181

  Psychiatry

  NPD (past) Authorized official
• Ehab Yacoub MD Inc.

  • Community/Behavioral Health Agency
  • Gardena, CA
  • NPI 1437539509

  Psychiatry

  NPD (past) Authorized official
• New Century Home Health, Inc

  • Home Health Agency
  • Van Nuys, CA
  • NPI 1447261375
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295884088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18546 ROSCOE BLVD",
            "address_2": "SUITE 210",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244663",
            "telephone_number": "818-886-5628",
            "fax_number": "818-701-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18546 ROSCOE BLVD",
            "address_2": "SUITE 210",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244663",
            "telephone_number": "818-886-5628",
            "fax_number": "818-701-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "EHAB",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A76244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kyoko Yamashita
• Jessica Lynn Yanez, RD

• Psychiatry Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.