Active NPI
Fadi Yacoub, MD
- Cardiovascular Disease Physician
- Brooklyn, NY
National Provider Identifier
1497216212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 25MA11478600
- Practice address
- 450 Clarkson Ave
Brooklyn, NY 11203-2012 - Phone
- (718) 270-2030
- NPI assigned
- Mar 26, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Cardiovascular Disease Physician | 207RC0000X | 25MA11478600 | NJ | Primary |
| Internal Medicine Physician | 207R00000X | 318838 | NY |
Addresses
Primary practice location
450 Clarkson Ave
Brooklyn, NY 11203-2012
Mailing address
450 Clarkson Ave # 1262
Brooklyn, NY 11203-2012
Phone (718) 270-2030
Other practice location 1
3201 Kings Hwy
Brooklyn, NY 11234-2625
Phone (718) 252-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 318838 | NY | MD | Internal Medicine Physician |
| 25MA11478600 | NJ | MD | Cardiovascular Disease Physician |
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icahn School of Medicine at Mount Sinai | Internal Medicine | Current | Accepting new patients |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Passaic Hospitalist Services, LLC | Current | Accepting new patients |
Locations
703 Main St
Paterson, NJ 07503
Phone (973) 754-2240
3201 Kings Hwy
Brooklyn, NY 11234
Phone (718) 252-3000
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
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.
-
- Internal Medicine Physician
- Brooklyn, NY
- NPI 1255719563
-
- Hospitalist Physician
- Paterson, NJ
- NPI 1144903733
-
- Specialist
- Elizabeth, NJ
- NPI 1841557246
-
- Eyewear Supplier
- New York, NY
- NPI 1760227466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775520000000",
"number": "1497216212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 CLARKSON AVE # 1262",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032012",
"telephone_number": "718-270-2030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 CLARKSON AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032012",
"telephone_number": "718-270-2030"
}
],
"practiceLocations": [
{
"address_1": "3201 Kings Hwy",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112342625",
"country_code": "US",
"telephone_number": "718-252-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YACOUB",
"first_name": "FADI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-26",
"last_updated": "2026-04-07",
"certification_date": "2026-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NJ",
"license": "25MA11478600",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "318838",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.