Individual provider Active NPI

Fadi Yacoub, MD

  • Cardiovascular Disease Physician
  • Brooklyn, NY
National Provider Identifier
1497216212
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA11478600 Issued in NJ
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

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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, NJ2 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
I20230223002873 NY Practitioner - Internal Medicine 3971976804 Reassigns benefits to 1 organization
I20240711001623 NJ Practitioner - Hospitalist 3971976804 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
318838NYMDInternal Medicine Physician
25MA11478600NJMDCardiovascular Disease Physician

Practice roles (3 of 7)

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Jan 8, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 8, 2023 Accepting new patients
Passaic Hospitalist Services, LLC CurrentSince Jun 1, 2024 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.

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

Verify at the official NPI Registry.