Individual provider Active NPI

Yasser Chebli, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Saint Paul, MN
National Provider Identifier
1366704553
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
60702 Issued in MN
Practice address
1700 University Ave W
Saint Paul, MN 55104-3727
Phone
(651) 232-2002
Fax
(651) 326-9635
NPI assigned
Jun 13, 2012
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3472740 IL
Geriatric Medicine (Family Medicine) Physician 207QG0300X 60702 MN Primary

Addresses

Primary practice location

1700 University Ave W
Saint Paul, MN 55104-3727

Mailing address

10961 Club West Pkwy
Blaine, MN 55449-5866
Phone (952) 914-1727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20160728002488 MN Practitioner - Family Practice 3173832359 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3472740ILMDFamily Medicine Physician
60702MNMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Jul 9, 2016 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Jul 9, 2016 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services CurrentSince Jul 9, 2016 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 1, 2021 Accepting new patients
Fairview Clinics CurrentSince Jul 9, 2016 Accepting new patients
Senior Care Forest Lake, LLC Past Accepting new patients
Benedictine Care Centers Past Accepting new patients
Parmly on the Lake LLC Past Accepting new patients
Ecumen Past Accepting new patients
Ebenezer Lakes Assisted Living Past Accepting new patients
Estates at Rush City LLC Past Accepting new patients
Elim Homes, Inc. Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

10961 Club West Pkwy
Minneapolis, MN 55449
Phone (763) 572-5700

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

Interoperability endpoints

  • Direct secure messaging: ychebli376923@fairview.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ebenezer RidgesBurnsville, MN, CCN 245213 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jan 1, 2020
Apr 16, 2025
Jones Harrison Residence CorporationMinneapolis, MN, CCN 245460 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Oct 1, 2023
Apr 21, 2025
Birchwood Health Care CenterForest Lake, MN, CCN 245200 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
May 1, 2022
May 1, 2022
Ebenezer Integrated Care & RehabSaint Paul, MN, CCN 245587 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jan 1, 2022
Apr 16, 2025
Meadows on FairviewWyoming, MN, CCN 245622 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jan 1, 2022
Apr 16, 2025
Aurora on FranceEdina, MN, CCN 245634 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jan 1, 2023
Apr 21, 2025

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1366704553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10961 CLUB WEST PKWY",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495866",
            "telephone_number": "952-914-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "651-232-2002",
            "fax_number": "651-326-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEBLI",
        "first_name": "YASSER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2024-01-29",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "3472740",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MN",
            "license": "60702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.