NPIMap

Individual provider Active NPI

Atef Labib Yacoub, M.D.

  • Urology Physician
  • Montebello, CA
National Provider Identifier
1740339894
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A40189 Issued in CA
Practice address
126 S Montebello Blvd
Montebello, CA 90640-4730
Phone
(323) 720-9204
Fax
(323) 720-9208
NPI assigned
Jan 9, 2007
Last updated
Dec 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A40189 CA Primary
General Practice Physician 208D00000X A40189 CA

Addresses

Primary practice location

126 S Montebello Blvd
Montebello, CA 90640-4730

Mailing address

PO Box 2199
Montebello, CA 90640-8099
Phone (323) 726-0533

Other identifiers 2

IdentifierTypeStateIssuer
GR0070010MedicaidCA
GR0070630MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041211000050 CA Practitioner - General PracticePractitioner - Urology 9931166964 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Urology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yacoub Medical, Inc.Group PAC ID 0446311542, 3 clinicians

Practice addresses (Care Compare)

120 S Montebello Blvd
Montebello, CA 90640-4730
Phone (323) 726-0533

126 S Montebello Blvd
Montebello, CA 90640-4730
Phone (323) 728-9300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A40189CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Urological & Surgical Group Urology CurrentSince Jan 1, 1989 Accepting new patients
Yacoub Medical, Inc. General Practice CurrentSince Oct 23, 2008 Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Alta Newport Hospital, LLC Past Accepting new patients
Alta Los Angeles Hospital, Inc Past Accepting new patients
Yacoub Medical, Inc. Past Accepting new patients
Montebello Urological Associates, AMC Past Accepting new patients
Trinity Urological and Surgical, Inc. Urology Past Accepting new patients
Northeast Hospital Corporation Past Accepting new patients
Alta Los Angeles Hospitals, Inc. Past Accepting new patients

Locations

120 S Montebello Blvd
Montebello, CA 90640
Phone (323) 720-9204

126 S Montebello Blvd
Montebello, CA 90640
Phone (213) 726-0454

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: aly102pcs@m1030.primeclinicalsystems.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Maywood Healthcare and Wellness CentreMaywood, CA, CCN 555130 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Jan 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1740339894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2199",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906408099",
            "telephone_number": "323-726-0533",
            "fax_number": "323-726-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S MONTEBELLO BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404730",
            "telephone_number": "323-720-9204",
            "fax_number": "323-720-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACOUB",
        "first_name": "ATEF",
        "middle_name": "LABIB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A40189",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A40189",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0070010",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0070630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.