Individual provider Active NPI

Mohamed K Youssef, MD

  • Interventional Pain Medicine Physician
  • Frederick, MD
National Provider Identifier
1346261385
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
D0069389 Issued in MD
Practice address
196 Thomas Johnson Dr
Suite 215
Frederick, MD 21702-4397
Phone
(301) 668-9988
Fax
(301) 898-2945
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 36089 IA
Interventional Pain Medicine Physician 208VP0014X D0069389 MD Primary

Addresses

Primary practice location

196 Thomas Johnson Dr
Suite 215
Frederick, MD 21702-4397

Mailing address

196 Thomas Johnson Dr
Suite 215
Frederick, MD 21702-4397
Phone (301) 668-9988

Other identifiers 1

IdentifierTypeStateIssuer
0463885MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0069389MDMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newbridge Surgery Center at Prince Frederick, LLC PastSince Dec 18, 2011 Accepting new patients
Frederick Health Hospital Inc Interventional Pain Medicine Past Accepting new patients

Organizations & group practices 2

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1346261385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 THOMAS JOHNSON DR",
            "address_2": "SUITE 215",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024397",
            "telephone_number": "301-668-9988",
            "fax_number": "301-898-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 THOMAS JOHNSON DR",
            "address_2": "SUITE 215",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024397",
            "telephone_number": "301-668-9988",
            "fax_number": "301-898-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSSEF",
        "first_name": "MOHAMED",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "36089",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MD",
            "license": "D0069389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463885",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.