Individual provider Active NPI

Ali Yousefi

  • Pharmacist
  • Bath, ME
National Provider Identifier
1962100438
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR71346 Issued in ME
Practice address
11 State Rd
Bath, ME 04530-6010
Phone
(207) 443-1786
Fax
(207) 442-6706
NPI assigned
Feb 23, 2023
Last updated
Feb 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PR71346 ME Primary

Addresses

Primary practice location

11 State Rd
Bath, ME 04530-6010

Mailing address

5 Hayfield LN
Lisbon, ME 04250-6899
Phone (713) 492-5734

Other names 1

  • Ali Yousefpour Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PR71346MEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Eastern Co Inc CurrentSince Feb 26, 2023 Accepting new patients

Locations

11 State Rd
Bath, ME 04530
Phone (207) 443-1786

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1962100438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HAYFIELD LN",
            "city": "LISBON",
            "state": "ME",
            "postal_code": "042506899",
            "telephone_number": "713-492-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 STATE RD",
            "city": "BATH",
            "state": "ME",
            "postal_code": "045306010",
            "telephone_number": "207-443-1786",
            "fax_number": "207-442-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSEFI",
        "first_name": "ALI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR71346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALI",
            "last_name": "YOUSEFPOUR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bath, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.