Individual provider Active NPI

Tony E Yusuf, M.D.

  • Gastroenterology Physician
  • Moses Lake, WA
National Provider Identifier
1366458309
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD61175547 Issued in WA
Practice address
840 E Hill Ave
Moses Lake, WA 98837-2238
Phone
(509) 663-8711
NPI assigned
Jul 31, 2006
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 14186911-1235 UT
Gastroenterology Physician 207RG0100X 46158 MN
Gastroenterology Physician 207RG0100X MD61175547 WA Primary

Addresses

Primary practice location

840 E Hill Ave
Moses Lake, WA 98837-2238

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Other practice location 1

3590 W 9000 S
West Jordan, UT 84088-8857
Phone (801) 208-1075

Other identifiers 2

IdentifierTypeStateIssuer
182338701MedicaidTX
8F6661OtherTXBCBS

Electronic endpoints 4

TypeEndpointUseAffiliation
FHIR URL tyusuf81271@edirect.chehr.org
Direct Messaging Address tyusuf81271@edirect.chehr.org
Direct Messaging Address tyusuf81271@edirect.chehr.org
FHIR URL tyusuf81271@edirect.chehr.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, HI, MN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20060914000210 TX Practitioner - GastroenterologyPractitioner - Geriatric Medicine 6709880248 Reassigns benefits to 1 organization
I20230503003245 HI Practitioner - Internal Medicine 6709880248 Reassigns benefits to 1 organization
I20250416002796 MN Practitioner - Gastroenterology 6709880248 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41479TXMDAmbulatory Care Pharmacist
MD61175547WAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hilo Benioff Medical Center CurrentSince Feb 21, 2023 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Hilo Benioff Medical Center CurrentSince Feb 21, 2023 Accepting new patients
Etmc Physician Group Inc. CurrentSince Jun 1, 2023 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Apr 14, 2025 Accepting new patients
Etmc Physician Group Inc. CurrentSince Jun 1, 2023 Accepting new patients
Starks Medical Past Accepting new patients
Physician Group of Utah Inc Past Accepting new patients

Locations

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

700 Olympic Plaza Cir
Ste 410
Tyler, TX 75701
Phone (903) 531-8950

Interoperability endpoints

  • Direct secure messaging: tyusuf840275@ahs.direct-ci.com
  • Direct secure messaging: tyusuf@yourcarecommunity.org

Organizations & group practices 8

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1366458309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E HILL AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372238",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3590 W 9000 S",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840888857",
            "country_code": "US",
            "telephone_number": "801-208-1075",
            "fax_number": "801-351-6735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUSUF",
        "first_name": "TONY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "UT",
            "license": "14186911-1235",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "46158",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD61175547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182338701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8F6661",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "tyusuf81271@edirect.chehr.org",
            "affiliation": "N",
            "address_1": "840 E Hill Ave",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988372238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyusuf81271@edirect.chehr.org",
            "affiliation": "N",
            "address_1": "840 E Hill Ave",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988372238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyusuf81271@edirect.chehr.org",
            "affiliation": "N",
            "address_1": "840 E Hill Ave",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988372238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "tyusuf81271@edirect.chehr.org",
            "affiliation": "N",
            "address_1": "840 E Hill Ave",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988372238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

Verify at the official NPI Registry.