Individual provider Active NPI

Shadi Yousefi, MD

  • Diagnostic Radiology Physician
  • Kensington, MD
National Provider Identifier
1174770606
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D74472 Issued in MD
Practice address
10810 Connecticut Ave
Kaiser Permanente Kensington Medical Center
Kensington, MD 20895-2138
Phone
(301) 929-7100
NPI assigned
Aug 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD039879 DC
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X D74472 MD Primary

Addresses

Primary practice location

10810 Connecticut Ave
Kaiser Permanente Kensington Medical Center
Kensington, MD 20895-2138

Mailing address

2101 E Jefferson St
Kaiser Permanente Medicare Enrollment
Rockville, MD 20852-4908
Phone (301) 816-2424

Electronic endpoints 3

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD, GA, HI5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20110901000230 DC Practitioner - Diagnostic Radiology 7113197096 Reassigns benefits to 1 organization
I20130911000169 VA Practitioner - Diagnostic Radiology 7113197096 Reassigns benefits to 1 organization
I20140115000577 MD Practitioner - Diagnostic Radiology 7113197096 Reassigns benefits to 1 organization
I20210825002368 GA Practitioner - Diagnostic Radiology 7113197096 Reassigns benefits to 1 organization
I20220518001461 HI Practitioner - Diagnostic Radiology 7113197096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

10810 Connecticut Ave
Kensington, MD 20895-2138
Phone (301) 929-7100

1201 Hospital Dr
Fredericksburg, VA 22401-8428
Phone (540) 368-3700

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone (703) 237-4800

1701 Twin Springs Rd
Halethorpe, MD 21227-3553
Phone (410) 737-5000

201 N Washington St
Falls Church, VA 22046-4518
Phone (703) 237-4000

2301 M St NW
Washington, DC 20037-1427
Phone (202) 419-6200

5100 Auth Way
Suitland, MD 20746-4207
Phone (301) 702-5000

5400 Hillmeade Rd
Bowie, MD 20720-4777
Phone (301) 867-1300

6104 Old Branch Ave
Temple Hills, MD 20748-2518
Phone (301) 702-6100

655 Watkins Mill Rd
Gaithersburg, MD 20879-3301
Phone (240) 632-4000

6551 Loisdale CT
Springfield, VA 22150-1828
Phone (703) 922-1000

6701 N Charles St
Baltamore, MD 21204-6808
Phone (443) 849-2000

7070 Samuel Morse Dr
Columbia, MD 21046-3424
Phone (410) 309-4600

7141 Security Blvd
Woodlawn Med Ctr
Baltimore, MD 21244-1811
Phone (443) 663-6000

8008 Westpark Dr
MC Lean, VA 22102-3109
Phone (703) 287-6400

815 E Pratt St
BHMC
Baltimore, MD 21202-4402
Phone (410) 637-5700

888 Bestgate Rd
Annapolis, MD 21401-3091
Phone (410) 571-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D74472MDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Diagnostic Radiology CurrentSince Oct 19, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Diagnostic Radiology Current Accepting new patients
The Southeast Permanente Medical Group Diagnostic Radiology CurrentSince Aug 5, 2021 Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince May 17, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 29, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Diagnostic Radiology CurrentSince Aug 6, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 29, 2013 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3649

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660

2391 Greenspring Dr
Timonium, MD 21093
Phone (410) 847-3000

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

1201 Hospital Dr
Fredericksburg, VA 22401
Phone (540) 368-3700

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Interoperability endpoints

  • Direct secure messaging: syousefi651349@direct.umm.edu

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1174770606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 CONNECTICUT AVE",
            "address_2": "KAISER PERMANENTE KENSINGTON MEDICAL CENTER",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952138",
            "telephone_number": "301-929-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSEFI",
        "first_name": "SHADI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DC",
            "license": "MD039879",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D74472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Mount Zion Pkwy",
            "city": "Jonesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302362500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Mount Zion Pkwy",
            "city": "Jonesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302362500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "2391 Greenspring Drive",
            "city": "Timonium",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kensington, MD

Sources for this page

Verify at the official NPI Registry.