Individual provider Active NPI

Maha Al-Yousefy

  • Critical Care Medicine (Internal Medicine) Physician
  • Fort Lee, NJ
National Provider Identifier
1306454632
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
25MP00579600 Issued in NJ
Practice address
458 West St
Fort Lee, NJ 07024-3408
Phone
(201) 474-7700
NPI assigned
Jul 22, 2020
Last updated
Dec 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00579600 NJ
Physician Assistant 363A00000X 02521501 NY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MP00579600 NJ Primary

Addresses

Primary practice location

458 West St
Fort Lee, NJ 07024-3408

Mailing address

331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877

Other practice location 1

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201202001301 NY Practitioner - Physician Assistant 3678984382 Reassigns benefits to 1 organization
I20241219000390 NJ Practitioner - Physician Assistant 3678984382 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
02521501NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Critical Care Medicine CurrentSince Oct 16, 2020 Accepting new patients
Montefiore Medical Center CurrentSince Oct 16, 2020 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Dec 17, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Dec 17, 2024 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0880

111 E 210th St
Bronx, NY 10467

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1306454632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015792",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 WEST ST",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243408",
            "telephone_number": "201-474-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "551-996-2211",
            "fax_number": "551-996-5727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-YOUSEFY",
        "first_name": "MAHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00579600",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "02521501",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MP00579600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

Verify at the official NPI Registry.