Individual provider Active NPI

Kameel Kassab, M.D.

  • Interventional Cardiology Physician
  • Yuma, AZ
National Provider Identifier
1760865596
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
64955 Issued in AZ
Practice address
1951 W 25TH St Ste F
Yuma, AZ 85364-6924
Phone
(928) 336-1675
Fax
(928) 336-1676
NPI assigned
Jun 29, 2015
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11018528A IN
Cardiovascular Disease Physician 207RC0000X 4301503549 MI
Interventional Cardiology Physician 207RI0011X 64955 AZ Primary

Addresses

Primary practice location

1951 W 25TH St Ste F
Yuma, AZ 85364-6924

Mailing address

2400 S Avenue a
Yuma, AZ 85364-7170
Phone (928) 344-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210707003200 MI Practitioner - Internal Medicine 3274845888 Reassigns benefits to 1 organization
I20220706003369 AZ Practitioner - Interventional Cardiology 3274845888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

11142 S Scottsdale Dr
Yuma, AZ 85367-5616
Phone (928) 336-1815

1965 W 24TH St
Suite a
Yuma, AZ 85364-6255
Phone (928) 344-5774

2360 S Ave a
Yuma, AZ 85364-7189
Phone (928) 336-2165

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

2451 S Ave a
Suite A104
Yuma, AZ 85364-7189
Phone (928) 336-2165

2500 S 8TH Ave
Suite 200
Yuma, AZ 85364-7108
Phone (928) 336-7095

3800 W 24TH St
Yuma, AZ 85364-9258
Phone (928) 336-3300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting55
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64955AZMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center Multi-Specialty CurrentSince Jul 20, 2022 Accepting new patients
Promed Healthcare CurrentSince Jul 1, 2021 Accepting new patients
Beacon Medical Group Michigan Inc Multi-Specialty Current Accepting new patients
Yuma Regional Medical Center Multi-Specialty CurrentSince Jul 20, 2022 Accepting new patients
Beacon Medical Group Michigan Inc Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients

Locations

1951 W 25th St
Ste F
Yuma, AZ 85364
Phone (928) 314-4800

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

2460 S Parkview Loop
Ste 204
Yuma, AZ 85364
Phone (928) 336-1675

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

1717 Shaffer St
Ste 002
Kalamazoo, MI 49048

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 5

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 1

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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1760865596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647170",
            "telephone_number": "928-344-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 W 25TH ST STE F",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646924",
            "telephone_number": "928-336-1675",
            "fax_number": "928-336-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSAB",
        "first_name": "KAMEEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-29",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11018528A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301503549",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AZ",
            "license": "64955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.