John Wageeh Mahrous Yacoub

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

035016 Issued in NY

Practice address

295 E Caroline St
San Bernardino, CA 92408-3700

Phone

(909) 723-1161

NPI assigned

Aug 18, 2014

Last updated

Dec 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All Star Physical TherapyGroup PAC ID 7719030949, 149 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• All Star Physical Therapy

  • Physical Therapist
  • Murrieta, CA
  • NPI 1750559431
  Medicare reassignment Care Compare group NPD
• Progressive Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Tarzana, CA
  • NPI 1184605586

  Physical Therapist

  NPD
• Elite Physical Therapy and Wellness, Inc.

  dba Elite Physical Therapy & Wellness

  • Physical Therapist
  • La Quinta, CA
  • NPI 1780702209
  NPD (past)

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1396144168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 SHORE PKWY APT 4J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112146142",
            "telephone_number": "440-654-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 E CAROLINE ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083700",
            "telephone_number": "909-723-1161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 E 58th St Ste 708",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100221133",
            "country_code": "US",
            "telephone_number": "212-371-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "JOHN",
        "middle_name": "WAGEEH MAHROUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-18",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292523",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quonteisha Wymbs
• Mariah I Wysinger
• Zuelika Cristina Xicotencatl
• Mike Xing, DDS
• Xiao-Ping Xu, ACUPUNCTURIST
• Nilda Yanez
• Grace Yang
• Robert Yang, M.D.
• Yang Yang, PHARM.D
• Yangrob's Medical Inc

• Physical Therapist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.