EANAS S YASSA


Address: 4069 Lake Dr Se, Suite 312, Grand Rapids, MI 49546-8816
Phone: 6162678700

EANAS S YASSA (NPI# 1396954376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396954376
Entity Type Individual
Full Name EANAS S YASSA
Credential M.D.
Practice Address 4069 Lake Dr Se
Suite 312
Grand Rapids
MI 49546-8816
Mailing Address 100 Michigan St Ne
Mc 845
Grand Rapids
MI 49503-2560
Practice Telephone 6162678700
Enumeration Date 2007-05-22
Last Update Date 2013-08-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0129X Surgery
Specialization: Vascular Surgery
4301104003 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI NPI 1396954376 01
MI 1396954376 05

Office Location

Street Address 4069 LAKE DR SE
SUITE 312
City GRAND RAPIDS
State MI
Zip Code 49546-8816

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811983000 Spectrum Health Durable Medical Equipment & Medical Supplies 4069 Lake Dr Se, Suite 210, Grand Rapids, MI 49546-8816 2005-09-22
1184070807 Danielle Wentworth Audiologist 4069 Lake Dr Se, Suite 315, Grand Rapids, MI 49546-8816 2016-05-12
1205253424 Elizabeth House Physician Assistant 4069 Lake Dr Se, Suite 312, Grand Rapids, MI 49546-8816 2014-03-26
1043655780 Spectrum Health Primary Care Partners Nutritionist 4069 Lake Dr Se, Ste. 315, Grand Rapids, MI 49546-8816 2013-05-08
1790025898 George Torao Sugiyama Surgery 4069 Lake Dr Se, Suite 312, Grand Rapids, MI 49546-8816 2013-02-26
1639442791 Debra Ann West Audiologist 4069 Lake Dr Se, Suite 315, Grand Rapids, MI 49546-8816 2012-02-20
1982976924 Ashley Lucas Physician Assistant 4069 Lake Dr Se, Suite 117, Grand Rapids, MI 49546-8816 2012-02-07
1861762122 Carley Therese Flegler Physician Assistant 4069 Lake Dr Se, Suite 313, Grand Rapids, MI 49546-8816 2012-01-04
1013227156 Spectrum Health Primary Care Partners Durable Medical Equipment & Medical Supplies 4069 Lake Dr Se, Suite 315, Grand Rapids, MI 49546-8816 2010-10-07
1285944322 Spectrum Health Primary Care Partners Durable Medical Equipment & Medical Supplies 4069 Lake Dr Se, Suite 314, Grand Rapids, MI 49546-8816 2010-10-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437762986 Amanda Mae Ostrom Speech-Language Pathologist 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 2020-08-25
1063075562 Kelly Lynn Ibarra Counselor 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 2019-04-19
1891257036 Jessica Matthews LLC Counselor 4127 Embassy Drive Se, Grand Rapids, MI 49546 2019-04-05
1326518531 Neah Morgan Technician 4220 Burton St Se, Grand Rapids, MI 49546 2018-11-29
1316430267 Michael John Benskey Case Manager/Care Coordinator 4065 Saladin St Se, Grand Rapids, MI 49546 2018-06-14
1679062772 Smile Cascade, P.C. Clinic/Center 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 2018-05-03
1720583289 Jeromy Krogman Counselor 826 Parchment Drive Se, Grand Rapids, MI 49546 2018-03-27
1841792660 Affordable Hearing Clinic Hearing Instrument Specialist 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 2018-03-07
1689176133 Kelly Pines Physical Therapist 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 2018-03-01
1467971440 Deanna Elizabeth Saenz Social Worker 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 2017-09-12
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Taxonomy Information

Taxonomy Code 2086S0129X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Vascular Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1558326009 Lee A Rea Surgery 4047 Saladin Dr Se, Grand Rapids, MI 49546-6249 2006-04-19
1467013698 Jake Anthony Nicholson Surgery 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503-2560 2019-06-27
1265927438 Ivan Noffsker Surgery 221 Michigan St Ne Ste 402, Grand Rapids, MI 49503-2538 2018-06-28
1427578004 Kush Sharma Surgery 221 Michigan St Ne Ste 402, Grand Rapids, MI 49503-2538 2017-06-23
1154772515 Joyce Lu Surgery 221 Michigan St Ne, Suite 200a, Grand Rapids, MI 49503-2543 2016-06-28
1790025898 George Torao Sugiyama Surgery 4069 Lake Dr Se, Suite 312, Grand Rapids, MI 49546-8816 2013-02-26
1194088120 Lindsey Marie Korepta Surgery 221 Michigan St Ne, Suite 200a, Grand Rapids, MI 49503-2543 2012-06-25
1578859542 Michelle Kosovec Surgery 310 Lafayette Ave Se, Suite 301, Grand Rapids, MI 49503-4693 2011-06-28
1700052230 Michigan Medical PC Surgery 2093 Health Dr Sw, Grand Rapids, MI 49519-9691 2008-05-05
1306018528 Michigan Medical Patient Care Surgery 4085 Burton St Se, Grand Rapids, MI 49546-2444 2008-03-27
Find all providers in GRAND RAPIDS

Competitor

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City GRAND RAPIDS
Zip Code 49546

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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