Individual provider Active NPI

Carl Ramses Yacoub, M.D.

  • Neurology Physician
  • Newark, DE
National Provider Identifier
1386651099
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
C1-0004626 Issued in DE
Practice address
1423 Capitol TRL Ste 1114
Newark, DE 19711-5709
Phone
(302) 996-9010
Fax
(302) 996-9027
NPI assigned
Aug 2, 2006
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X C1-0004626 DE Primary

Addresses

Primary practice location

1423 Capitol TRL Ste 1114
Newark, DE 19711-5709

Mailing address

1423 Capitol TRL Ste 1114
Newark, DE 19711-5709
Phone (302) 996-9010

Other identifiers 1

IdentifierTypeStateIssuer
0001164401MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20120126000678 DE Practitioner - Neurology 0840223145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1423 Capitol TRL
Suite 1114
Newark, DE 19711-5709
Phone (302) 996-9010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0004626DEMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acclaim Neurodiagnostics Group Neurology CurrentSince Mar 20, 2021 Accepting new patients

Locations

1423 Capitol Trl
Ste 1114
Newark, DE 19711
Phone (302) 932-9456

537 Stanton Christiana Rd
Ste 106
Newark, DE 19713
Phone (302) 996-5457

Interoperability endpoints

  • Direct secure messaging: acclaimneurology.carlyacoub@154859.advancedmd-direct.com

Organizations & group practices 3

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 1

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1386651099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 CAPITOL TRL STE 1114",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197115709",
            "telephone_number": "302-996-9010",
            "fax_number": "302-996-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 CAPITOL TRL STE 1114",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197115709",
            "telephone_number": "302-996-9010",
            "fax_number": "302-996-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "CARL",
        "middle_name": "RAMSES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "DE",
            "license": "C1-0004626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001164401",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.