Individual provider Active NPI

Yasameen Amer Kerakhan, MD

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1427630938
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35150987 Issued in OH
Practice address
3425 Executive Pkwy Ste 100
Toledo, OH 43606-1326
Phone
(419) 472-1224
Fax
(419) 786-8857
NPI assigned
Apr 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35150987 OH Primary

Addresses

Primary practice location

3425 Executive Pkwy Ste 100
Toledo, OH 43606-1326

Mailing address

3425 Executive Pkwy Ste 100
Toledo, OH 43606-1326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240923002646 OH Practitioner - Family Practice 6002357670 Reassigns benefits to 1 organization
I20251117001405 AZ Practitioner - Family Practice 6002357670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance Medical Clinic LLCGroup PAC ID 1557374931, 7 clinicians
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians

Practice addresses (Care Compare)

34225 N 27TH Dr
Suite 114
Phoenix, AZ 85085-6088
Phone (623) 505-6565

3425 Executive Pkwy
Suite 100
Toledo, OH 43606-1326
Phone (419) 472-1124

42104 N Venture Dr
D118
Anthem, AZ 85086-3837

Hospital & facility affiliations

  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35150987OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Clinic, LLC CurrentSince Nov 15, 2025 Accepting new patients
Mercy Health Physicians-North LLC Family Medicine CurrentSince Aug 12, 2024 Accepting new patients
Signify Health, LLC CurrentSince Dec 31, 2025 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Aug 12, 2024 Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

42104 N Venture Dr
Ste D118
Phoenix, AZ 85086
Phone (623) 505-4479

3425 Executive Pkwy
Ste 100
Toledo, OH 43606
Phone (419) 472-1124

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

2200 Jefferson Ave
Toledo, OH 43604
Phone (419) 241-1400

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8857/brand/1/csg/1/fhir/r4
  • Direct secure messaging: yasameen.kerakhan.1@8857.direct.athenahealth.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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1427630938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 EXECUTIVE PKWY STE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 EXECUTIVE PKWY STE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061326",
            "telephone_number": "419-472-1224",
            "fax_number": "419-786-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERAKHAN",
        "first_name": "YASAMEEN",
        "middle_name": "AMER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2024-06-05",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35150987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.