Individual provider Active NPI

Hussein Kharroubi, MD

  • Surgery Physician
  • Augusta, GA
National Provider Identifier
1083403406
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
17501 Issued in GA
Practice address
1459 Laney Walker Blvd
Augusta, GA 30912-0001
Phone
(706) 721-7005
NPI assigned
May 2, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 17501 GA Primary

Addresses

Primary practice location

1459 Laney Walker Blvd
Augusta, GA 30912-0001

Mailing address

1459 Laney Walker Blvd
Augusta, GA 30912-0001
Phone (706) 721-7005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250725001749 GA Order and Referring Only - General SurgeryPractitioner - General Surgery 7416464474

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17501GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical College of Georgia CurrentSince Jun 15, 2025 Accepting new patients

Locations

1459 Laney Walker Blvd
Augusta, GA 30912
Phone (706) 721-2423

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1083403406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 LANEY WALKER BLVD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120001",
            "telephone_number": "706-721-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 LANEY WALKER BLVD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120001",
            "telephone_number": "706-721-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHARROUBI",
        "first_name": "HUSSEIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "17501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.