Individual provider Active NPI

Eanas S Yassa, M.D.

  • Vascular Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1396954376
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301104003 Issued in MI
Practice address
275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone
(616) 267-8700
Fax
(616) 267-8247
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 4301104003 MI Primary

Addresses

Primary practice location

275 Michigan St NE
Grand Rapids, MI 49503-2531

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Other identifiers 2

IdentifierTypeStateIssuer
1396954376MedicaidMI
1396954376OtherMINPI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Eanas.Yassa@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20131001000574 MI Practitioner - Vascular Surgery 2668606898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Michigan State University College of Human Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

221 Michigan St NE
300 Corewell Health Medical Group West
Grand Rapids, MI 49503-2537
Phone (616) 459-7258

2249 Wealthy St SE
110 Corewell Health Medical Group West
East Grand Rapids, MI 49506-3055
Phone (616) 391-4600

275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone (616) 267-8700

2776 S State Rd
Ionia, MI 48846-8472
Phone (616) 267-8700

4069 Lake Dr SE
Grand Rapids, MI 49546-8816

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

588 E Lakewood Blvd FL
Holland, MI 49424-2023

6105 Wilson Ave SW
Wyoming, MI 49418-9714

6105 Wilson Ave SW FL
2 Corewell Health Medical Group West
Wyoming, MI 49418-9714
Phone (616) 267-8950

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jul 31, 2013 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 31, 2013 Accepting new patients
Spectrum Health Hospitals Past Accepting new patients

Locations

705 Oak St
Big Rapids, MI 49307
Phone (231) 592-4356

230 W Oak St
Fremont, MI 49412
Phone (231) 924-1305

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

4069 Lake Dr SE
Ste 312
Grand Rapids, MI 49546
Phone (616) 267-8700

100 Michigan St NE
Ste 8830
Grand Rapids, MI 49503
Phone (616) 459-7258

221 Michigan St NE
Ste 300
Grand Rapids, MI 49503
Phone (616) 459-7258

275 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7900

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

4069 Lake Dr SE
Ste 114
Grand Rapids, MI 49546
Phone (616) 267-8346

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

705 S Greenville West Dr
Ste 202
Greenville, MI 48838
Phone (616) 267-9823

1005 W Green St
Ste 202
Hastings, MI 49058
Phone (269) 948-0078

602 Michigan Ave
Ste 102
Holland, MI 49423
Phone (616) 392-3824

588 E Lakewood Blvd
Holland, MI 49424
Phone (616) 494-5800

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1675 E Mount Garfield Rd
Muskegon, MI 49444
Phone (231) 799-8880

1845 Holton Rd
North Muskegon, MI 49445
Phone (231) 291-8399

6105 Wilson Ave SW
Wyoming, MI 49418
Phone (616) 486-5055

Interoperability endpoints

  • Direct secure messaging: eanas.yassa@epic00.shdirect.org
  • Direct secure messaging: eyassa84170@epic00.corewelldirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1396954376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032531",
            "telephone_number": "616-267-8700",
            "fax_number": "616-267-8247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASSA",
        "first_name": "EANAS",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301104003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396954376",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396954376",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Eanas.Yassa@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "4069 Lake Dr SE",
            "address_2": "Suite 312",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4069 Lake Dr SE",
            "address_2": "Suite 312",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.