Active NPI
Yakdan Taha Al Qaisi, MD
- Family Medicine Physician
- Bakersfield, CA
National Provider Identifier
1811068869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A88720
- Practice address
- 4040 San Dimas St
Suite a
Bakersfield, CA 93301-1298 - Phone
- (661) 363-6800
- Fax
- (661) 363-6888
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A88720 | CA | Primary |
Addresses
Primary practice location
4040 San Dimas St
Suite a
Bakersfield, CA 93301-1298
Mailing address
4040 San Dimas St
Suite a
Bakersfield, CA 93301-1298
Phone (661) 363-6800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811068869 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071203000291 | CA | Practitioner - Family Practice | 2769571512 |
Reassigns benefits to 1 organization Practice locations: Bakersfield, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
4040 San Dimas St
Suite a
Bakersfield, CA 93301-1299
Phone (661) 363-6800
Hospital & facility affiliations
- Professional Nursing Inc
- Pro Nursing Home Care, Inc
- Primamed Health Services Inc.
- Adventist Health Bakersfield
- Mercy Hospital
- Valley Healthcare Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 19 |
| Removal of nail tissue | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Health & Wellness | Family Medicine | Current | Accepting new patients |
| Yaqsa, Inc. | Family Medicine | Current | Accepting new patients |
| Bounty Land Medical Centers LLC | Past | Accepting new patients | |
| Schall Chiropractic Inc | Past | Accepting new patients | |
| Bountyland Medical Center LLC | Past | Accepting new patients |
Locations
4040 San Dimas St
Ste A
Bakersfield, CA 93301
Phone (661) 363-6800
20241 W Valley Blvd
Ste D
Tehachapi, CA 93561
Phone (661) 822-0811
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.
-
- Federally Qualified Health Center (FQHC)
- Mariposa, CA
- NPI 1891207684
CA
-
- Chiropractor
- Tehachapi, CA
- NPI 1508969171
-
- Chiropractor
- Seneca, SC
- NPI 1699637710
-
- Chiropractor
- Seneca, SC
- NPI 1689779688
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Bakersfield, CA
- NPI 1659947398
-
- Home Health Agency
- Bakersfield, CA
- NPI 1295182830
-
- Home Health Agency
- Studio City, CA
- NPI 1659577971
-
- Skilled Nursing Facility
- Bakersfield, CA
- NPI 1144911199
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1811068869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4040 SAN DIMAS ST",
"address_2": "SUITE A",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933011298",
"telephone_number": "661-363-6800",
"fax_number": "661-363-6888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4040 SAN DIMAS ST",
"address_2": "SUITE A",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933011298",
"telephone_number": "661-363-6800",
"fax_number": "661-363-6888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AL QAISI",
"first_name": "YAKDAN",
"middle_name": "TAHA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A88720",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1811068869",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.