Organization Active NPI

Northeast Clinic PLLC

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1508711235
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHEAST CLINIC PLLC
Practice address
3620 Central Ave NE Ste 4
Minneapolis, MN 55418-1377
Phone
(763) 744-7960
Fax
(952) 242-9153
NPI assigned
Feb 27, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Authorized official

Name
Amin Mohammed Yousuf, PA-CNPI 1558685834
Title
Ceo
Phone
(763) 744-7960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3620 Central Ave NE Ste 4
Minneapolis, MN 55418-1377

Mailing address

3620 Central Ave NE Ste 4
Minneapolis, MN 55418-1377
Phone (763) 744-7960

National Provider Directory

National Provider Directory

Locations

3620 Central Ave NE
Ste 4
Minneapolis, MN 55418
Phone (763) 744-7960

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1772150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772150400000",
    "number": "1508711235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 CENTRAL AVE NE STE 4",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554181377",
            "telephone_number": "763-744-7960",
            "fax_number": "952-242-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 CENTRAL AVE NE STE 4",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554181377",
            "telephone_number": "763-744-7960",
            "fax_number": "952-242-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A",
        "authorized_official_last_name": "YOUSUF",
        "authorized_official_first_name": "AMIN",
        "authorized_official_middle_name": "MOHAMMED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-744-7960",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.