NPIMap

Individual provider Active NPI

Wina Poriescha Yousman, M.D.

  • Internal Medicine Physician
  • Flagstaff, AZ
National Provider Identifier
1275981458
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
60584 Issued in AZ
Practice address
617 N Humphreys St Ste 102
Flagstaff, AZ 86001-3063
Phone
(480) 610-6100
NPI assigned
May 29, 2016
Last updated
Sep 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 60584 AZ Primary

Addresses

Primary practice location

617 N Humphreys St Ste 102
Flagstaff, AZ 86001-3063

Mailing address

2610 N 3Rd St
Phoenix, AZ 85004-1102
Phone (480) 610-6100

Other practice location 1

214 S Main St
Cottonwood, AZ 86326-3907
Phone (480) 610-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210225001906 AZ Practitioner - Internal Medicine 9234420977 Reassigns benefits to 1 organization
I20211007001059 TX Practitioner - Internal Medicine 9234420977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Kidney Institute PLCGroup PAC ID 8224930987, 100 clinicians

Practice addresses (Care Compare)

2610 N 3Rd St
Phoenix, AZ 85004-1102
Phone (480) 610-6100

Highway 191 and Hospital Rd
Chinle, AZ 86503-8000
Phone 92867470307030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.02 of 100Reported as group
Quality
69.14
Promoting interoperability
100
Improvement activities
40
Cost
77.59

Merit-based Incentive Payment System (MIPS)

Final score
80.86 of 100Reported as group
Quality
61.32
Improvement activities
40
Cost
90.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60584AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Apr 2, 2024 Accepting new patients
Southwest Kidney Institute, PLC Nephrology CurrentSince Nov 21, 2020 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility Current Accepting new patients
Southwest Kidney Institute, PLC Nephrology CurrentSince Nov 21, 2020 Accepting new patients
Southwest Kidney Institute, PLC Nephrology CurrentSince Nov 21, 2020 Accepting new patients

Locations

214 S Main St
Cottonwood, AZ 86326
Phone (928) 634-7534

617 N Humphreys St
Ste 102
Flagstaff, AZ 86001

2610 N 3rd St
Phoenix, AZ 85004
Phone (602) 264-3541

9305 W Thomas Rd
Ste 255
Phoenix, AZ 85037
Phone (623) 247-9235

1845 W Orange Grove Rd
Ste 111
Tucson, AZ 85704
Phone (520) 329-8298

905 N Bowie Ave
Willcox, AZ 85643
Phone (520) 326-4811

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2697/brand/1/csg/22/fhir/r4
  • Direct secure messaging: wina.yousman.1@2697.direct.athenahealth.com

Organizations & group practices 5

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

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1275981458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041102",
            "telephone_number": "480-610-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 N HUMPHREYS ST STE 102",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013063",
            "telephone_number": "480-610-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 S Main St",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863263907",
            "country_code": "US",
            "telephone_number": "480-610-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUSMAN",
        "first_name": "WINA",
        "middle_name": "PORIESCHA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-29",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "60584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.