NPIMap

Individual provider Active NPI

Hussam Kujok, MD

  • Internal Medicine Physician
  • Carmichael, CA
National Provider Identifier
1013081611
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A92291 Issued in CA
Practice address
3609 Mission Ave
Suite a
Carmichael, CA 95608-2955
Phone
(916) 971-9000
Fax
(916) 971-9010
NPI assigned
Nov 17, 2006
Last updated
Mar 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A92291 CA
Internal Medicine Physician 207R00000X 4301095251 MI
Internal Medicine Physician 207R00000X A92291 CA Primary

Addresses

Primary practice location

3609 Mission Ave
Suite a
Carmichael, CA 95608-2955

Mailing address

3609 Mission Ave
Suite a
Carmichael, CA 95608-2955
Phone (916) 971-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070412000192 CA Practitioner - Internal Medicine 1557466000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3609 Mission Ave
Suite a
Carmichael, CA 95608-2955
Phone (916) 971-9000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A92291CAMDInternal Medicine Physician
4301095251MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Prime Healthcare, Inc. Current Accepting new patients
Hussam Kujok MD Inc Internal Medicine CurrentSince Jul 1, 2011 Accepting new patients
R.C. Hospice Care, Inc. Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hkujok81898@hisp.ehr.sutterhealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
KH Prime Hospice CareSacramento, CA, CCN B41742 Hospice 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer
Corporate Director
Operational/Managerial Control		 Apr 21, 2023
Apr 21, 2023
Apr 21, 2023
Apr 21, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • American Prime Healthcare, Inc.

    dba KH Prime Hospice Care

    • Community Based Hospice Care Agency
    • Sacramento, CA
    • NPI 1295400869

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control

    CMS ownership

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1013081611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 MISSION AVE",
            "address_2": "SUITE A",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956082955",
            "telephone_number": "916-971-9000",
            "fax_number": "916-971-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 MISSION AVE",
            "address_2": "SUITE A",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956082955",
            "telephone_number": "916-971-9000",
            "fax_number": "916-971-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUJOK",
        "first_name": "HUSSAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A92291",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301095251",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A92291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.