Individual provider Active NPI

Nagy A. Youssef, MD

  • Psychiatry Physician
  • Grand Rapids, MI
National Provider Identifier
1336156991
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301510689 Issued in MI
Practice address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone
(616) 455-5270
NPI assigned
Aug 3, 2006
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.142232 OH
Psychiatry Physician 2084P0800X 4301510689 MI Primary

Addresses

Primary practice location

300 68TH St SE
Grand Rapids, MI 49548-6927

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Other identifiers 3

IdentifierTypeStateIssuer
08302032MedicaidMS
1336156991MedicaidMI
PENDINGMedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PineRestCMHS@directaddress.pinerest.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150514001257 GA Practitioner - Psychiatry 7719945583 Reassigns benefits to 1 organization
I20231218000794 MI Practitioner - Psychiatry 7719945583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Merit-based Incentive Payment System (MIPS)

Final score
50.74 of 100Reported as group
Quality
0
Promoting interoperability
99
Improvement activities
0
Cost
57.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301510689MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Mar 1, 2015 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Dec 1, 2023 Accepting new patients
Pine Rest Christian Mental Health Services Psychiatry CurrentSince Dec 1, 2023 Accepting new patients
Au Medical Associates Inc CurrentSince Mar 1, 2015 Accepting new patients
Pine Rest Christian Mental Health Services Current Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1336156991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSSEF",
        "first_name": "NAGY",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.142232",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301510689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08302032",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336156991",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PineRestCMHS@directaddress.pinerest.org",
            "affiliation": "N",
            "address_1": "300 68th St SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495486927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.