Active NPI
Yaser Hany Elqutub, DO
- Family Medicine Physician
- Dallas, TX
National Provider Identifier
1033778980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- T1057
- Practice address
- 4300 N Central Expy Ste 365
Dallas, TX 75206-6532 - Phone
- (281) 536-1469
- Fax
- (606) 259-9165
- NPI assigned
- Jun 12, 2019
- Sex
- Male
- Sole proprietor
- No
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 | T1057 | TX | Primary |
Addresses
Primary practice location
4300 N Central Expy Ste 365
Dallas, TX 75206-6532
Mailing address
4300 N Central Expy Ste 365
Dallas, TX 75206-6532
Phone (281) 536-1469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 1, 2026 through Jun 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712793600000",
"number": "1033778980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 N CENTRAL EXPY STE 365",
"city": "DALLAS",
"state": "TX",
"postal_code": "752066532",
"telephone_number": "281-536-1469",
"fax_number": "606-259-9165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 N CENTRAL EXPY STE 365",
"city": "DALLAS",
"state": "TX",
"postal_code": "752066532",
"telephone_number": "281-536-1469",
"fax_number": "606-259-9165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELQUTUB",
"first_name": "YASER",
"middle_name": "HANY",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-12",
"last_updated": "2024-04-11",
"certification_date": "2024-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "T1057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.