Individual provider Active NPI

Ismail Yahyazade, MD

  • Psychiatry Physician
  • Groton, CT
National Provider Identifier
1801832928
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A44958 Issued in CA
Practice address
Route 12 BLDG 449
Naval Ambulatory Care Center Attn Professional Affairs
Groton, CT 06349-5600
Phone
(860) 694-2377
Fax
(860) 694-2590
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A44958 CA Primary

Addresses

Primary practice location

Route 12 BLDG 449
Naval Ambulatory Care Center Attn Professional Affairs
Groton, CT 06349-5600

Mailing address

3 Briars Corners
Briar Cliff Manor, NY 10510
Phone (914) 432-5590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A44958CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801832928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BRIARS CORNERS",
            "city": "BRIAR CLIFF MANOR",
            "state": "NY",
            "postal_code": "10510",
            "telephone_number": "914-432-5590",
            "fax_number": "914-762-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 12 BLDG 449",
            "address_2": "NAVAL AMBULATORY CARE CENTER ATTN PROFESSIONAL AFFAIRS",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAHYAZADE",
        "first_name": "ISMAIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A44958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.