NPIMap

Individual provider Active NPI

Mohammad Yousuf, MD

  • Internal Medicine Physician
  • Dyersburg, TN
National Provider Identifier
1881634103
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30495 Issued in TN
Practice address
1950 Cook St
Suite D
Dyersburg, TN 38024-1899
Phone
(731) 285-7999
Fax
(731) 285-6917
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30495 TN Primary

Addresses

Primary practice location

1950 Cook St
Suite D
Dyersburg, TN 38024-1899

Mailing address

1765 Putter LN
Dyersburg, TN 38024-8899
Phone (731) 285-7999

Other identifiers 1

IdentifierTypeStateIssuer
3730733MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050728001147 TN Practitioner - Internal Medicine 1951339118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Choice Medical Care PLLCGroup PAC ID 6901838242, 2 clinicians

Practice addresses (Care Compare)

1950 Cook St
Suite D
Dyersburg, TN 38024-1899
Phone (731) 285-7999

1950 Cook St D
Dyersburg, TN 38024-1899

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30495TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Medical Care PLLC Internal Medicine CurrentSince Aug 1, 2005 Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Independent Radiology Associates PLC Past Accepting new patients
Emergency Coverage, LLC Internal Medicine Past Accepting new patients

Locations

1950 Cook St
Ste D
Dyersburg, TN 38024
Phone (731) 285-7999

Interoperability endpoints

  • Direct secure messaging: mohammad.yousuf@1stchoice.directbygreenway.com
  • Direct secure messaging: myousuf@yourcarecommunity.org

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881634103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 PUTTER LN",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380248899",
            "telephone_number": "731-285-7999",
            "fax_number": "731-285-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 COOK ST",
            "address_2": "SUITE D",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380241899",
            "telephone_number": "731-285-7999",
            "fax_number": "731-285-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSUF",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "30495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3730733",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

Verify at the official NPI Registry.