Individual provider Active NPI

Youssef A Hannallah, M.D.

  • Internal Medicine Physician
  • Secaucus, NJ
National Provider Identifier
1760424378
Registry record updated Apr 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06231700 Issued in NJ
Practice address
255 Route 3 East
Suite 107
Secaucus, NJ 07094-3857
Phone
(201) 330-3335
Fax
(201) 330-3326
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA06231700 NJ Primary

Addresses

Primary practice location

255 Route 3 East
Suite 107
Secaucus, NJ 07094-3857

Mailing address

211 Darwin Ave
Rutherford, NJ 07070-1306
Phone (201) 330-3335

Other identifiers 1

IdentifierTypeStateIssuer
6956700MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040526000030 NJ Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - Pediatric Medicine 6103807243 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine, Pediatric Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians

Practice addresses (Care Compare)

1355 Broad St
Clifton, NJ 07013-4221
Phone (973) 778-5566

557 Broad St
Bloomfield, NJ 07003-2885
Phone (973) 680-8300

622 Franklin Ave
Nutley, NJ 07110-1247
Phone (973) 661-1900

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MPV New Jersey MD Services PC CurrentSince Apr 15, 2023 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Apr 15, 2023 Accepting new patients
Central Jersey Emergency Medicine Associates, PC CurrentSince Nov 4, 2018 Accepting new patients
SKR Medical Advisors CurrentSince Jun 1, 2019 Accepting new patients
The Radiology Group of New Jersey, LLC PastSince Jun 1, 2019 Accepting new patients
Hogarth Emergency Physicians Past Accepting new patients

Locations

557 Broad St
Bloomfield, NJ 07003
Phone (973) 680-8300

1355 Broad St
Clifton, NJ 07013
Phone (973) 778-5566

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

560 New York Ave
Lyndhurst, NJ 07071
Phone (201) 345-3839

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

2100 88th St
Bldg G
North Bergen, NJ 07047
Phone (201) 345-3839

2100 88th St
Bldg G1A
North Bergen, NJ 07047
Phone (201) 773-1360

Interoperability endpoints

  • Direct secure messaging: yhannallah865572@ahs.direct-ci.com
  • Direct secure messaging: yhannallah425171@direct.ahsys.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207440000000",
    "number": "1760424378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 DARWIN AVE",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701306",
            "telephone_number": "201-330-3335",
            "fax_number": "201-330-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 ROUTE 3 EAST",
            "address_2": "SUITE 107",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943857",
            "telephone_number": "201-330-3335",
            "fax_number": "201-330-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNALLAH",
        "first_name": "YOUSSEF",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2008-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06231700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6956700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

Verify at the official NPI Registry.