Individual provider Active NPI

Wael Hussein

  • Nephrology Physician
  • Memphis, TN
National Provider Identifier
1104172378
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
64134 Issued in TN
Practice address
1325 Eastmoreland Ave Ste 445
Memphis, TN 38104-7536
Phone
(901) 866-8810
Fax
(901) 302-2450
NPI assigned
Jul 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 64134 TN Primary

Addresses

Primary practice location

1325 Eastmoreland Ave Ste 445
Memphis, TN 38104-7536

Mailing address

1068 Cresthaven Rd Ste 300
Memphis, TN 38119-0809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20250204001836 TN Practitioner - Nephrology 6406386671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Medical Group IncGroup PAC ID 3173435369, 98 clinicians

Practice addresses (Care Compare)

1325 Eastmoreland Ave
Suite 445
Memphis, TN 38104-7536
Phone (901) 866-8810

Hospital & facility affiliations

  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Regional One Health Hospital, Memphis, TN, CCN 440152

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Medical Group Inc CurrentSince Feb 1, 2025 Accepting new patients
Ut Medical Group, Inc. CurrentSince Feb 1, 2025 Accepting new patients

Locations

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

1325 Eastmoreland Ave
Ste 445
Memphis, TN 38104
Phone (901) 866-8810

1068 Cresthaven Rd
Ste 300
Memphis, TN 38119
Phone (901) 683-0024

1407 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 866-8360

Interoperability endpoints

  • Direct secure messaging: whussein105151@mlh.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1104172378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE STE 445",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381047536",
            "telephone_number": "901-866-8810",
            "fax_number": "901-302-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSEIN",
        "first_name": "WAEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-25",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "64134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.