NPIMap

Organization Active NPI

Pediatrics of St. Augustine

  • Pediatrics Physician
  • St Augustine, FL
National Provider Identifier
1457565947
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME87309 Issued in FL
Legal business name
PEDIATRICS OF ST. AUGUSTINE
Practice address
2676 US Highway 1 S
St Augustine, FL 32086-6191
Phone
(904) 797-2121
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Dr. Aliya M Yasin, MDNPI 1841266061
Title
President
Phone
(904) 797-2121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME87309 FL Primary

Addresses

Primary practice location

2676 US Highway 1 S
St Augustine, FL 32086-6191

Mailing address

2676 US Highway 1 S
St Augustine, FL 32086-6191
Phone (904) 797-2121

National Provider Directory

National Provider Directory

Locations

2676 US Highway 1 S
Saint Augustine, FL 32086
Phone (904) 797-2121

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1457565947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2676 US HIGHWAY 1 S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866191",
            "telephone_number": "904-797-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2676 US HIGHWAY 1 S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866191",
            "telephone_number": "904-797-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS OF ST. AUGUSTINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "YASIN",
        "authorized_official_first_name": "ALIYA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-797-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME87309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.