Mohammad Yunus MD PA

Key facts

NPI

1104088657

Entity type

Organization (NPI type 2)

Primary specialty

Rural Health Clinic/Center 261QR1300X

License

ME27818 (FL)

Legal business name

MOHAMMAD YUNUS MD PA

Practice address

404 E Highway 90
Bonifay, FL 32425-2731

Phone

(850) 547-4284

Fax

(850) 547-5145

NPI assigned

Jun 26, 2008

Organization subpart

No

Authorized official

Name

Mr. Mohammad Yunus, M.D. NPI 1730165259

Title

Owner/Physician

Phone

(850) 547-4284

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Mohammad Yunus, MD Internal Medicine Physician · Bonifay, FL · NPI 1730165259
  CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · W-2 MANAGING EMPLOYEE

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mohammad Yunus MD PA Internal Medicine Physician · Bonifay, FL · NPI 1740559715
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammad Yunus, MD Internal Medicine Physician · Bonifay, FL · NPI 1730165259
  Medicare reassignment NPD Authorized official FL
• Dawn Rene Frost, 363L00000X Family Nurse Practitioner · Chipley, FL · NPI 1215981667
  Medicare reassignment NPD FL
• Paula Denise Stanley Family Nurse Practitioner · Bonifay, FL · NPI 1669984654
  Medicare reassignment NPD FL

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in FL

Rural health clinic certification: CCN 103882

Legal name

MOHAMMAD YUNUS MD PA

Doing business as

YUNUS RURAL HEALTH

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Oct 27, 1994

Last certification

Mar 7, 2023

Ownership / control type

1B

Organization structure

Corporation · Proprietary

Incorporated

Jan 1, 1989 in FL

Enrollment address

404 E Highway 90
Bonifay, FL 32425-2731

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Medicare enrollment records

National Provider Directory

Tax ID family

Mohammad Yunus MD PA (2 organizations share this tax ID)

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 6, 2017.

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1104088657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 E HIGHWAY 90",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324252731",
            "telephone_number": "850-547-4284",
            "fax_number": "850-547-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E HIGHWAY 90",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324252731",
            "telephone_number": "850-547-4284",
            "fax_number": "850-547-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMMAD YUNUS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "YUNUS",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "850-547-4284",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME27818",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "FL",
            "license": "ME27818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660039500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonifay, FL

• Emery Shyanne Mayo, RBT
• Ruby J McKay
• Medical Gallery, LLC
• Medsouth Home Health L.L.C.
• Mary Elizabeth Miller, LMHC
• Mohammad Yunus MD PA
• Richard James Moore, D.O.
• Hannah Moran
• MTM Specialist
• Nemours Children'S Health, Bonifay, Specialty Care

All providers in Bonifay, FL · Rural Health Clinic/Center in Florida