Individual provider Active NPI

Ali Yassen, M.D.

  • Interventional Cardiology Physician
  • Santa Rosa, CA
National Provider Identifier
1528359296
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A154552 Issued in CA
Practice address
3536 Mendocino Ave Ste 200
Santa Rosa, CA 95403
Phone
(707) 573-6166
Fax
(707) 573-6165
NPI assigned
Apr 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A154552 CA
Interventional Cardiology Physician 207RI0011X A154552 CA Primary

Addresses

Primary practice location

3536 Mendocino Ave Ste 200
Santa Rosa, CA 95403

Mailing address

3536 Mendocino Ave Ste 200
Santa Rosa, CA 95403-3634
Phone (707) 525-6485

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20200218000401 VA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 4284875923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retreat Cardiology LLCGroup PAC ID 5395838361, 13 clinicians

Practice addresses (Care Compare)

7101 Jahnke Rd
Richmond, VA 23225-4017
Phone (804) 320-3911

Hospital & facility affiliations

  • Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118

Merit-based Incentive Payment System (MIPS)

Final score
78.02 of 100Reported as group
Quality
54.15
Promoting interoperability
99
Improvement activities
40
Cost
73.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154552CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retreat Cardiology LLC Cardiovascular Disease CurrentSince Jul 22, 2024 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

7603 Forest Ave
Ste 202
Richmond, VA 23229
Phone (804) 285-5165

7702 E Parham Rd
Ste 106
Richmond, VA 23294
Phone (804) 346-2070

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

505 W Leigh St
Ste 205
Richmond, VA 23220
Phone (804) 562-2769

7129 Jahnke Rd
Richmond, VA 23225
Phone (804) 269-5112

Interoperability endpoints

  • Direct secure messaging: ayassen417338@hisp.ehr.sutterhealth.org
  • Direct secure messaging: ali.yassen@hca6.eclinicaldirectplus.com
  • Direct secure messaging: ayassen560804@direct.sentara.net

Organizations & group practices 1

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 1

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": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1528359296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033634",
            "telephone_number": "707-525-6485",
            "fax_number": "707-573-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95403",
            "telephone_number": "707-573-6166",
            "fax_number": "707-573-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASSEN",
        "first_name": "ALI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-28",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A154552",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A154552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3536 Mendocino Ave Ste 200",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.