Individual provider Active NPI

Rabi Yacoub, M.D.

  • Nephrology Physician
  • Buffalo, NY
National Provider Identifier
1497987093
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
274643 Issued in NY
Practice address
Elm and Carlton St
Buffalo, NY 14263-0001
Phone
(716) 845-2300
NPI assigned
Aug 14, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 274643 NY Primary

Addresses

Primary practice location

Elm and Carlton St
Buffalo, NY 14263-0001

Mailing address

1 Old Mill Run
Depew, NY 14043-5008
Phone (716) 609-8855

Other practice location 1

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-4226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150717001761 NY Practitioner - Nephrology 2668785726 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Academic Medicine Services, Inc.Group PAC ID 0941105241, 115 clinicians

Practice addresses (Care Compare)

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-5671

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
274643NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ub Family Medicine, Inc Current Accepting new patients
Academic Medicine Services, Inc. CurrentSince Jul 1, 2015 Accepting new patients
Roswell Park Cancer Institute CurrentSince Oct 1, 2022 Accepting new patients
Roswell Park Cancer Institute CurrentSince Oct 1, 2022 Accepting new patients
University at Buffalo Surgeons Inc Past Accepting new patients

Locations

462 Grider St
Fl 11
Buffalo, NY 14215
Phone (716) 898-4803

Dept 8000
Buffalo, NY 14267

77 Goodell St
Ste 320
Buffalo, NY 14203

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

Elm and Carlton St
Buffalo, NY 14263

462 Grider St
#11
Buffalo, NY 14215

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

Interoperability endpoints

  • Direct secure messaging: rabiyacoub@ubmd.allscriptsdirect.net

Organizations & group practices 5

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": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1497987093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OLD MILL RUN",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140435008",
            "telephone_number": "716-609-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 Grider St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142153021",
            "country_code": "US",
            "telephone_number": "716-898-4226",
            "fax_number": "716-898-3928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "RABI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-14",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "274643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.