Individual provider Active NPI

Mohammad M Yousef, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Edgewood, KY
National Provider Identifier
1346321478
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
48648 Issued in KY
Practice address
1 Medical Village Dr
St Elizabeth Healthcare
Edgewood, KY 41017-3403
Phone
(859) 301-2018
Fax
(859) 301-2073
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X TP696 KY
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 4301087420 MI
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 48648 KY Primary

Addresses

Primary practice location

1 Medical Village Dr
St Elizabeth Healthcare
Edgewood, KY 41017-3403

Mailing address

PO Box 636324
St Elizabeth Healthcare
Cincinnati, OH 45263-6324
Phone (859) 301-2018

Other identifiers 2

IdentifierTypeStateIssuer
0149808MedicaidOH
7100384310MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 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
I20151116000305 KY Practitioner - Pathology 9133293137 Reassigns benefits to 1 organization
I20230623000714 IN Practitioner - Pathology 9133293137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Elizabeth Medical Center, IncGroup PAC ID 0648174623, 187 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2237

600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (859) 301-2465

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP696KYMDCardiovascular Disease Physician
48648KYMDAnatomic Pathology & Clinical Pathology Physician
4301087420MIMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc 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.

Hospital & facility affiliations 4

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1346321478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636324",
            "address_2": "ST ELIZABETH HEALTHCARE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636324",
            "telephone_number": "859-301-2018",
            "fax_number": "859-301-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "address_2": "ST ELIZABETH HEALTHCARE",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-2018",
            "fax_number": "859-301-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSEF",
        "first_name": "MOHAMMAD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "TP696",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MI",
            "license": "4301087420",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "48648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149808",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100384310",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.