Individual provider Active NPI

Bahishta Yaqubi

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1780061036
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME137122 Issued in FL
Practice address
506 6TH St
Brooklyn, NY 11215-3609
Phone
(904) 206-3507
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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 ME137122 FL Primary

Addresses

Primary practice location

506 6TH St
Brooklyn, NY 11215-3609

Mailing address

506 6TH St
Brooklyn, NY 11215-3609
Phone (904) 206-3507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190117000738 FL Practitioner - Internal Medicine 7315283090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone (386) 586-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Florida IV, LLC Internal Medicine CurrentSince Oct 15, 2022 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Dec 12, 2018 Accepting new patients
Sound Physicians of Florida IV, LLC Internal Medicine CurrentSince Oct 15, 2022 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Dec 12, 2018 Accepting new patients

Locations

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

3100 E Fletcher Ave
#C
Tampa, FL 33613

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Organizations & group practices 4

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.

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1780061036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "904-206-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "904-206-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAQUBI",
        "first_name": "BAHISHTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME137122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.