Active NPI
Sumera Yaqub, M.D.
- Internal Medicine Physician
- Evansville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- FY5568019
- Practice address
- 3700 Washington Ave
Evansville, IN 47714-0541 - Phone
- (812) 485-7040
- Fax
- (812) 485-7042
- NPI assigned
- Jul 6, 2010
- Last updated
- Jun 26, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | FY5568019 | IN | Primary |
| Internal Medicine Physician | 207R00000X | 2010014300 | MO |
Addresses
Primary practice location
3700 Washington Ave
Evansville, IN 47714-0541
Mailing address
12101 Woodcrest Executive Dr Ste 210
Saint Louis, MO 63141-5047
Phone (314) 317-0600
Other practice location 1
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 317-0600
Other practice location 2
12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 317-0600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356653463 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3700 Washington Ave
Evansville, IN 47714-0541
Phone (812) 485-4000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010014300 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Physician Services PC | Internal Medicine | Current | Accepting new patients |
| St Mary's Medical Group, LLC | Internal Medicine | Current | Accepting new patients |
| St Mary's Medical Group, LLC | Current | Accepting new patients |
Locations
1116 Millis Ave
Boonville, IN 47601
Phone (812) 897-4800
3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021
801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236
250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331
12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360
12380 De Paul Dr
Bridgeton, MO 63044
Phone (314) 447-9700
10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522
Interoperability endpoints
- sumera.yaqub.p1@direct.phcenters.nextgenshare.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Ascension Medical Group St. Vincent Evansville
- Family Medicine Physician
- Evansville, IN
- NPI 1164852539
Internal Medicine
-
- Hospitalist Physician
- Oak Ridge, TN
- NPI 1083835441
Internal Medicine, MO
-
- Internal Medicine Physician
- Bridgeton, MO
- NPI 1962971531
-
dba Ascension Medical Group St. Vincent Evansville
- Nephrology Physician
- Evansville, IN
- NPI 1619307873
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ascension St. Vincent Evansville
- General Acute Care Hospital
- Evansville, IN
- NPI 1427082957
-
dba Ascension St. Vincent Evansville
- Rehabilitation Hospital Unit
- Evansville, IN
- NPI 1912005661
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750896000000",
"number": "1356653463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12101 WOODCREST EXECUTIVE DR STE 210",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631415047",
"telephone_number": "314-317-0600",
"fax_number": "314-317-0606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 WASHINGTON AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477140541",
"telephone_number": "812-485-7040",
"fax_number": "812-485-7042"
}
],
"practiceLocations": [
{
"address_1": "12303 De Paul Dr",
"address_purpose": "LOCATION",
"city": "Bridgeton",
"state": "MO",
"postal_code": "630442512",
"country_code": "US",
"telephone_number": "314-317-0600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12303 De Paul Dr",
"address_purpose": "LOCATION",
"city": "Bridgeton",
"state": "MO",
"postal_code": "630442512",
"country_code": "US",
"telephone_number": "314-317-0600",
"fax_number": "314-317-0606",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YAQUB",
"first_name": "SUMERA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-06",
"last_updated": "2025-06-26",
"certification_date": "2025-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "FY5568019",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2010014300",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1356653463",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.