Active NPI
Nimo Yousuf, OD
- Optometrist
- Phoenix, AZ
National Provider Identifier
1275000168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 002313
- Practice address
- 4570 E Cactus Rd
Phoenix, AZ 85032-7702 - Phone
- (602) 242-1105
- NPI assigned
- Oct 29, 2018
- Last updated
- Mar 20, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 002313 | AZ | Primary |
Addresses
Primary practice location
4570 E Cactus Rd
Phoenix, AZ 85032-7702
Mailing address
5232 W Apollo Rd
Laveen, AZ 85339-6912
Phone (602) 790-2482
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 11, 2023 through Oct 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002313 | AZ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710892800000",
"number": "1275000168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5232 W APOLLO RD",
"city": "LAVEEN",
"state": "AZ",
"postal_code": "853396912",
"telephone_number": "602-790-2482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4570 E CACTUS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850327702",
"telephone_number": "602-242-1105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUSUF",
"first_name": "NIMO",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-29",
"last_updated": "2024-03-20",
"certification_date": "2024-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "002313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.