Active NPI
Ismail Usamah Yasin, CRNA
- Registered Nurse
- Bronx, NY
National Provider Identifier
1679322507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 706617
- Practice address
- 111 E 210TH St
Bronx, NY 10467-2401 - Phone
- (718) 920-4411
- NPI assigned
- May 14, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 706617 | NY | Primary |
Addresses
Primary practice location
111 E 210TH St
Bronx, NY 10467-2401
Mailing address
16 White Birch Way
Wappingers Falls, NY 12590-7515
Phone (917) 510-7795
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321
Hospital & facility affiliations
- Montefiore Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 706617 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Medical Center | Current | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Interoperability endpoints
- iyasin@montefioredirect.com
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Bronx, NY
- NPI 1063525152
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1952476988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715644800000",
"number": "1679322507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 WHITE BIRCH WAY",
"city": "WAPPINGERS FALLS",
"state": "NY",
"postal_code": "125907515",
"telephone_number": "917-510-7795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E 210TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104672401",
"telephone_number": "718-920-4411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YASIN",
"first_name": "ISMAIL",
"middle_name": "USAMAH",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-14",
"last_updated": "2024-05-14",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "706617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.