Active NPI
Mushtaba Yuridullah
- Emergency Medicine Physician
- Round Rock, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- U3699
- Practice address
- 300 University Blvd
Round Rock, TX 78665-1032 - Phone
- (512) 509-0100
- NPI assigned
- Mar 27, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | U3699 | TX | Primary |
Addresses
Primary practice location
300 University Blvd
Round Rock, TX 78665-1032
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | myuridullah1198906@direct.sw.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| U3699 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott & White Hospital - Taylor | Current | Accepting new patients | |
| Century Integrated Partners, Inc | Emergency Medicine | Current | Accepting new patients |
| Scott & White Hospital - Taylor | Current | Accepting new patients | |
| Scott & White Hospital - Taylor | Emergency Medicine | Current | Accepting new patients |
Locations
5245 W Highway 290
Austin, TX 78735
Phone (512) 509-0100
1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559
2600 E Pflugerville Pkwy
Ste 100
Pflugerville, TX 78660
Phone (512) 654-6100
4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000
300 University Blvd
Round Rock, TX 78665
Phone (512) 509-0100
305 Mallard Ln
Taylor, TX 76574
Phone (512) 352-7611
Interoperability endpoints
- myuridullah1198906@direct.sw.org
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Dallas, TX
- NPI 1447615711
-
- Nurse Practitioner
- Taylor, TX
- NPI 1659548568
-
- Critical Access Hospital
- Taylor, TX
- NPI 1962497800
-
- Emergency Medicine Physician
- Taylor, TX
- NPI 1659366557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689120000000",
"number": "1306307939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658",
"telephone_number": "800-994-0371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 UNIVERSITY BLVD",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786651032",
"telephone_number": "512-509-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YURIDULLAH",
"first_name": "MUSHTABA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-27",
"last_updated": "2023-07-12",
"certification_date": "2023-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "U3699",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "myuridullah1198906@direct.sw.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "300 University Blvd",
"city": "Round Rock",
"state": "TX",
"country_code": "US",
"postal_code": "786651032",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.