Raed Al Yacoub, M.D.
Individual provider Active NPI Hospice and Palliative Medicine (Internal Medicine) Physician · Gainesville, FL
NPI 1942688239 · NPPES record last updated Jan 13, 2025
Key facts
- NPI
- 1942688239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X
- License
- ME139692 (FL)
- Practice address
- 1600 SW Archer Rd
Gainesville, FL 32610-3003 - Phone
- (352) 294-8278
- Fax
- (352) 265-0379
- NPI assigned
- May 7, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Hospice/Palliative Care
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Florida Clinical Practice Association Inc
Practice addresses (Care Compare)
1600 SW Archer
Gainesville, FL 32610-3003
1600 SW Archer Rd
Gainesville, FL 32610-3003
1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535
2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250
2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990
Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161
Hospital & facility affiliations
- Uf Health Shands Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 47.54 of 100
- Quality
- 38.49
- Promoting interoperability
- 0
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191008001274 | FL | Practitioner - Hospice/Palliative Care |
4688905508 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME139692 | FL | MD | Hospice and Palliative Medicine (Internal Medicine) Physician |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Clinical Practice Association Inc | Current |
Accepting new patients | |
| Florida Clinical Practice Association Inc | Internal Medicine | Current |
Accepting new patients |
Locations
1600 SW Archer Rd
#100371
Gainesville, FL 32610
Phone (352) 265-8335
2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990
1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077
Networks
- Freedom Health HMO Network
Interoperability endpoints
- ralyacoub423749@direct.shands.ufl.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME139692 | FL | |
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | ME139692 | FL | Yes |
Addresses
Primary practice location
1600 SW Archer Rd
Gainesville, FL 32610-3003
Mailing address
462 Grider St.
Ecmc
Buffalo, NY 14213
Phone (716) 898-4226
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104002700 | Medicaid | FL |
Other providers in Gainesville, FL
- Neama Al Atassi
- Lubna Mustafa Al Hourani
- Fatima Al Maaz
- Shehd Abdullah Abbas Al Rubaiy
- Mohammed Izzeddin Al Said
- Osama Al Zoubi
- Lara Saoud Al-Agailat
- Ma'Moon Mohammad Amin Al-Ahmad
- Mohammad Ahmad Zaki Al-Ani
- Danah Al-Atari
All providers in Gainesville, FL · Hospice and Palliative Medicine (Internal Medicine) Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.