Individual provider Active NPI

Syed Yousaf Ali Shah, MD

  • Pulmonary Disease Physician
  • Bristol, TN
National Provider Identifier
1306407580
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
72796 Issued in TN
Practice address
1 Medical Park Blvd Ste 205E
Bristol, TN 37620-7507
Phone
(423) 844-5520
NPI assigned
Jun 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 72796 TN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 72796 TN
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X 72796 TN Primary

Addresses

Primary practice location

1 Medical Park Blvd Ste 205E
Bristol, TN 37620-7507

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

1276 Gilbreath Dr Dept Of
Johnson City, TN 37614-6503
Phone (423) 439-6283

Other practice location 2

Johnson City Medical Center
400 N State of Franklin Rd,
Johnson City, TN 37604
Phone (423) 431-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250530002438 TN Practitioner - Pulmonary Disease 0345759510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Suite 205E
Bristol, TN 37620-7507
Phone (423) 844-5520

Hospital & facility affiliations

  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72796TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc Internal Medicine Current Accepting new patients
Wellmont Medical Associates, Inc. Internal Medicine CurrentSince Jul 1, 2025 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Blue Ridge Medical Management Corporation Past Accepting new patients

Locations

1 Medical Park Blvd
Ste 205E
Bristol, TN 37620
Phone (423) 844-5520

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

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.

Hospital & facility affiliations 5

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": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1306407580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111",
            "fax_number": "423-282-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD STE 205E",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207507",
            "telephone_number": "423-844-5520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1276 Gilbreath Dr Dept Of",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376146503",
            "country_code": "US",
            "telephone_number": "423-439-6283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "JOHNSON CITY MEDICAL CENTER",
            "address_2": "400 N State of Franklin Rd,",
            "address_purpose": "LOCATION",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SYED YOUSAF ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "72796",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "72796",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "72796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.