Individual provider Active NPI

Akinolu Tajudeen Yussuf

  • Medical Physician Assistant
  • Lafayette, IN
National Provider Identifier
1649874850
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10003495A Issued in IN
Practice address
3920 St Francis Way Ste 220
Lafayette, IN 47905-4922
Phone
(765) 428-5950
Fax
(765) 428-5951
NPI assigned
Nov 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10003495A IN Primary

Addresses

Primary practice location

3920 St Francis Way Ste 220
Lafayette, IN 47905-4922

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

604 Fairfax Ave Apt E
Norfolk, VA 23507-2069
Phone (314) 308-7274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220316002698 IN Practitioner - Physician Assistant 8426443169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

1020 N 18TH St
Lafayette, IN 47904-2279
Phone (765) 420-8028

150 W Washington St
Shelbyville, IN 46176-1236
Phone (317) 865-5904

1701 S Creasy Lane
Lafayette, IN 47905-4972
Phone (765) 502-4000

1701 S Creasy LN
Lafayette, IN 47905-4972

1702 Lafayette Rd
Crawfordsville, IN 47933-1033
Phone (765) 362-4400

1704 Lafayette Rd
Crawfordsville, IN 47933-1071

1706 Lafayette Rd
Crawfordsville, IN 47933-1033
Phone (765) 775-2800

1710 Lafayette Rd
Crawfordsville, IN 47933-1033
Phone (765) 364-8942

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10003495AINMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Jan 10, 2022 Accepting new patients
Franciscan Physician Network CurrentSince Jan 10, 2022 Accepting new patients

Locations

1704 Lafayette Rd
Ste 8
Crawfordsvlle, IN 47933
Phone (317) 528-4251

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

3920 St Francis Way
Ste 220
Lafayette, IN 47905
Phone (765) 428-5950

826 N 6th St
Monticello, IN 47960
Phone (574) 583-1924

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

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 6

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": "1606521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1649874850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 ST FRANCIS WAY STE 220",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054922",
            "telephone_number": "765-428-5950",
            "fax_number": "765-428-5951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 Fairfax Ave Apt E",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235072069",
            "country_code": "US",
            "telephone_number": "314-308-7274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUSSUF",
        "first_name": "AKINOLU",
        "middle_name": "TAJUDEEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-28",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10003495A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.