Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexandra Isabella Yacub

Individual provider Family Nurse Practitioner · NPI 1003523754

Alexandra Isabella Yacub is a Nurse Practitioner in Buffalo, New York. Qualified in 2022, 4 years ago. Practices with Jericho Road Ministries, Inc, a 33-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
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Practice location Address checks out

1021 Broadway St
Buffalo, NY 14212-1460
Phone: (716) 529-3020
Fax: (716) 529-3040
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F350635 (NY)

Record details

NPI number1003523754
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 2, 2022
Last updated in NPPESSeptember 19, 2024
Certification dateSeptember 19, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Jericho Road Ministries, Inc. — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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