Shady Khairy Iskander Yassa

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1829 Putnam Ave
Ridgewood, NY 11385-4247

Phone

(718) 337-1100

NPI assigned

Aug 3, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Bright Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Brooklyn, NY
  • NPI 1841980638
  NPD Authorized official
• Ameristar Home Care Services, LLC.

  • Home Health Agency
  • Far Rockaway, NY
  • NPI 1902279425
  NPD (past)

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501718400000",
    "number": "1669996385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 BEACH 20TH ST LOWR LEVEL",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913618",
            "telephone_number": "718-337-1100",
            "fax_number": "718-337-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 PUTNAM AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113854247",
            "telephone_number": "718-337-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASSA",
        "first_name": "SHADY",
        "middle_name": "KHAIRY ISKANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-03",
        "last_updated": "2017-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xinyi TCM LLC
• Yar Trading Corp
• Tristan Yarter, PT, DPT
• Yasik 2 Inc
• Yasik 2 Inc
• Ya-Hsiu Yen, M.D.
• Dae Han Yoo, PHARMD
• Abeir A Younise
• Josephine Youssef
• Mariana Nashaat Youssef

• Physical Therapist in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; 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.