Individual provider Active NPI

Sami F Yasin, M.D.

  • Internal Medicine Physician
  • Wantage, NJ
National Provider Identifier
1316007651
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05330800 Issued in NJ
Practice address
199 State RT 284
Wantage, NJ 07461-3417
Phone
(973) 875-7121
Fax
(973) 875-7123
NPI assigned
Dec 9, 2006
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 197792-1 NY
Internal Medicine Physician 207R00000X 25MA05330800 NJ Primary
Infectious Disease Physician 207RI0200X 25MA05330800 NJ
Infectious Disease Physician 207RI0200X 197792-1 NY

Addresses

Primary practice location

199 State RT 284
Wantage, NJ 07461-3417

Mailing address

199 State RT 284
Wantage, NJ 07461-3417
Phone (973) 875-7121

Other identifiers 3

IdentifierTypeStateIssuer
01496762MedicaidNY
CI4224OtherNJRAILROAD MEDICARE
342010801MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sami.yasin.1@16368.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20051019000068 NJ Practitioner - Internal MedicinePractitioner - Infectious Disease 1355367400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

199 State RT
284 Suite 200
Wantage, NJ 07461-3419
Phone (973) 875-7121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05330800NJMDInternal Medicine Physician
197792-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tristate Wellness & Medical Care PA Internal Medicine CurrentSince Oct 2, 2013 Accepting new patients

Locations

199 State Rt 284
Wantage, NJ 07461
Phone (845) 412-9682

199 State Rt 284
Ste 200
Wantage, NJ 07461
Phone (973) 875-7121

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16368/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 7

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": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1316007651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 STATE RT 284",
            "city": "WANTAGE",
            "state": "NJ",
            "postal_code": "074613417",
            "telephone_number": "973-875-7121",
            "fax_number": "973-875-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 STATE RT 284",
            "city": "WANTAGE",
            "state": "NJ",
            "postal_code": "074613417",
            "telephone_number": "973-875-7121",
            "fax_number": "973-875-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASIN",
        "first_name": "SAMI",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "197792-1",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05330800",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "25MA05330800",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "197792-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01496762",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI4224",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342010801",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sami.yasin.1@16368.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "199 State Rt 284",
            "city": "Wantage",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "074613417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wantage, NJ

Sources for this page

Verify at the official NPI Registry.