Robert Michael Yacoub, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13019 TPA Issued in CA

Practice address

2575 Yorba Linda Blvd
Fullerton, CA 92831-1615

Phone

(714) 992-7842

Fax

(714) 992-7867

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marshall B Ketchum UniversityGroup PAC ID 9739075177, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Marshall B. Ketchum University

  • Optometrist
  • Anaheim, CA
  • NPI 1720101876
  Medicare reassignment Care Compare group NPD
• Marshall B. Ketchum University

  • Multi-Specialty Clinic/Center
  • Anaheim, CA
  • NPI 1174037493
  NPD

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1306973110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 WEDGEWOOD WAY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862140",
            "telephone_number": "714-328-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 YORBA LINDA BLVD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928311615",
            "telephone_number": "714-992-7842",
            "fax_number": "714-992-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13019 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan Xie, LA.C.
• XS Medical
• Patricia Xu, OTR/L
• Y-Be Headquarters, Inc.
• Marina Yacoub
• Benjamin C Yaffee
• Ruth Ashley Yagual, LVN
• Kai Yakushko
• Richard Lee Yamasaki, PA
• Cassie Yambao

• Optometrist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.