Organization Active NPI

My Doctor Youssef Medical PLLC

  • Pediatric Adolescent Medicine Physician
  • Forest Hills, NY
National Provider Identifier
1598140949
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
199752-1 Issued in NY
Legal business name
MY DOCTOR YOUSSEF MEDICAL PLLC
Practice address
103-11 68TH Drive
Forest Hills, NY 11375
Phone
(347) 642-5315
Fax
(347) 642-9859
NPI assigned
Jul 28, 2015
Last updated
Jul 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Authorized official

Name
Mr. Maged Z Youssef-Ahmed, M.D.NPI 1053474866
Title
Medical Doctor
Phone
(718) 869-1542

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
Pediatric Adolescent Medicine Physician 2080A0000X 199752-1 NY Primary

Addresses

Primary practice location

103-11 68TH Drive
Forest Hills, NY 11375

Mailing address

103-11 68TH Drive
Forest Hills, NY 11375
Phone (718) 869-1542

Other identifiers 1

IdentifierTypeStateIssuer
01625007MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151019000908 NY Part B Supplier - Clinic/Group Practice 1052620861 Receives reassigned benefits from 1 practitioner
Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1598140949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103-11 68TH DRIVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-869-1542",
            "fax_number": "347-642-9859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103-11 68TH DRIVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "347-642-5315",
            "fax_number": "347-642-9859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DOCTOR YOUSSEF MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "YOUSSEF-AHMED",
        "authorized_official_first_name": "MAGED",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "718-869-1542",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "199752-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01625007",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.