Individual provider Active NPI

Kamalullah Yusufzie, M.D.

  • Internal Medicine Physician
  • Modesto, CA
National Provider Identifier
1497710594
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A94145 Issued in CA
Practice address
2717 Prosperity Way
Modesto, CA 95355-8647
Phone
(209) 526-3863
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TP351 KY
Adult Medicine Physician 207QA0505X A94145 CA
Internal Medicine Physician 207R00000X A94145 CA Primary

Addresses

Primary practice location

2717 Prosperity Way
Modesto, CA 95355-8647

Mailing address

2717 Prosperity Way
Modesto, CA 95355-8647
Phone (209) 526-3863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070122000195 CA Practitioner - Internal MedicinePractitioner - Family Practice 5698711968 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94145CAMDInternal Medicine Physician
94145CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Merced Hospitalist Medical Group, Inc. Internal Medicine CurrentSince Nov 30, 2012 Accepting new patients
Hospitalists of Modesto Medical Group Inc Internal Medicine CurrentSince Apr 13, 2019 Accepting new patients
West Coast Hospitalists PC Internal Medicine Past Accepting new patients
Norton Enterprises, Inc. Past Accepting new patients
Gold Country Emergency Physicians Medical Group Inc Past Accepting new patients

Locations

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1700 McHenry Ave
Ste 65B
Modesto, CA 95350
Phone (209) 581-7063

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1497710594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 PROSPERITY WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953558647",
            "telephone_number": "209-526-3863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 PROSPERITY WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953558647",
            "telephone_number": "209-526-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSUFZIE",
        "first_name": "KAMALULLAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "TP351",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A94145",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A94145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.