Individual provider Active NPI

Qurratulain Yousuf, PA-C

  • Physician Assistant
  • Grapevine, TX
National Provider Identifier
1336893916
Registry record updated Oct 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15549 Issued in TX
Practice address
1120 S Main St Ste 100
Grapevine, TX 76051-5640
Phone
(817) 416-5554
NPI assigned
Feb 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA15549 TX Primary

Addresses

Primary practice location

1120 S Main St Ste 100
Grapevine, TX 76051-5640

Mailing address

6011 Harry Hines Blvd
Dallas, TX 75235-5386
Phone (214) 645-8250

Other practice location 1

3166 S State Highway 161 Ste 170
Grand Prairie, TX 75052-7720
Phone (972) 640-0005

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230207003702 TX Practitioner - Physician Assistant 6901278589 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Pediatrics & Infectious Disease Associates CurrentSince Nov 5, 2023 Accepting new patients
Little Spurs Pediatric Urgent Care, PLLC PastSince Sep 1, 2022 Accepting new patients

Locations

1120 S Main St
Ste 100
Grapevine, TX 76051
Phone (817) 416-5554

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698537600000",
    "number": "1336893916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355386",
            "telephone_number": "214-645-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S MAIN ST STE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515640",
            "telephone_number": "817-416-5554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3166 S State Highway 161 Ste 170",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750527720",
            "country_code": "US",
            "telephone_number": "972-640-0005",
            "fax_number": "210-314-5044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUSUF",
        "first_name": "QURRATULAIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2023-10-29",
        "certification_date": "2023-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.