Individual provider Active NPI

Jeffrey David Yusim, M.D.

  • Family Medicine Physician
  • Vista, CA
National Provider Identifier
1659355907
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A45129 Issued in CA
Practice address
950 East Vista Way
Suite C
Vista, CA 92084-5252
Phone
(760) 295-7677
Fax
(760) 295-7690
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A45129 CA Primary

Addresses

Primary practice location

950 East Vista Way
Suite C
Vista, CA 92084-5252

Mailing address

950 East Vista Way
Suite C
Vista, CA 92084-5252
Phone (760) 295-7677

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
I20150108000530 CA Practitioner - Family Practice 3577599299 Practice locations: Vista, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A45129CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Qualitycare Medical Center Current Accepting new patients
Vista Immediate Care Past Accepting new patients
Jeffrey D Yusim MD Family Medicine PastSince Apr 24, 2013 Accepting new patients
Qualitycare Medical Center PastSince May 26, 2010 Accepting new patients

Locations

840 Townsite Dr
Vista, CA 92084
Phone (619) 630-2422

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1659355907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 EAST VISTA WAY",
            "address_2": "SUITE C",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845252",
            "telephone_number": "760-295-7677",
            "fax_number": "760-295-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 EAST VISTA WAY",
            "address_2": "SUITE C",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845252",
            "telephone_number": "760-295-7677",
            "fax_number": "760-295-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSIM",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A45129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.