Yazan Abdeen, M.D.
Individual provider Active NPI Pulmonary Disease Physician · Newark, NJ
NPI 1679983605 · NPPES record last updated Aug 11, 2020
Key facts
- NPI
- 1679983605
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- 25MA09388600 (NJ)
- Practice address
- 111 Central Ave
Newark, NJ 07102-1909 - Phone
- (973) 877-5485
- NPI assigned
- Apr 29, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Vigilias LLC
Pulmonary and Sleep Physicians of Houston, P.a.
Lone Star Intensivists at Gulf Coast, PLLC
Practice addresses (Care Compare)
425 N Belmont Ave
Wichita, KS 67208-3810
Phone 3165007549700
501 Orchard St
Suite 200
Webster, TX 77598-4146
Phone (281) 557-8555
504 Medical Ctr Blvd
Conroe, TX 77304-2808
Phone (936) 539-1111
Hospital & facility affiliations
- HCA Houston Healthcare Pearland
- HCA Houston Healthcare Clear Lake
- Houston Methodist Clear Lake Hospital
- Memorial Hermann Hospital System
- HCA Houston Healthcare Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200402000997 | TX | Practitioner - Critical Care (Intensivists) |
6800101593 | Reassigns benefits to 2 organizations |
| I20241021002441 | KS | Practitioner - Internal Medicine |
6800101593 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09388600 | NJ | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vigilias LLC | Current |
Accepting new patients | |
| Lone Star Intensivists at Gulf Coast, PLLC | Critical Care Medicine | Current |
Accepting new patients |
| Pulmonary and Sleep Physicians of Houston, P.a. | Pulmonary Disease | Current |
Accepting new patients |
| Cardiovascular Care Providers, Inc. | Past | Accepting new patients |
Locations
4723 E Douglas Ave
Wichita, KS 67218
Phone (316) 670-3800
504 Medical Center Blvd
Conroe, TX 77304
Phone (936) 539-1111
12141 Richmond Ave
Houston, TX 77082
Phone (281) 558-3444
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IICCCA
- yabdeen707115@directb.mercy.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 25MA09388600 | NJ | |
| Pulmonary Disease Physician | 207RP1001X | 25MA09388600 | NJ | Yes |
Addresses
Primary practice location
111 Central Ave
Newark, NJ 07102-1909
Mailing address
6 Patton Dr
Bloomfield, NJ 07003-5216
Phone (908) 422-6063
Other providers in Newark, NJ
- Yazan Abboud
- Malaz A Abdalla
- Rawan Abdalla
- Saeed Khalifa Abdallah
- Ahmed Magdy Mahmoud Abdaltawab
- Ahmad Abdel Fattah
- Nadeem Abdel-Jawad
- Andrew Abdelmalek
- Girom Abdelmesih
- Nehal Abdelmoneim
All providers in Newark, NJ · Pulmonary Disease Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.