Individual provider Active NPI

Ali K Husain, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Salem, VA
National Provider Identifier
1124040472
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
0101255992 Issued in VA
Practice address
1802 Braeburn Dr
Suite 1310
Salem, VA 24153-7357
Phone
(540) 776-2020
Fax
(540) 776-2017
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 00497 NC
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 0101255992 VA Primary

Addresses

Primary practice location

1802 Braeburn Dr
Suite 1310
Salem, VA 24153-7357

Mailing address

1802 Braeburn Dr
Suite 1310
Salem, VA 24153-7357
Phone (540) 776-2020

Other identifiers 3

IdentifierTypeStateIssuer
1124040472MedicaidVA
1263KOtherNCBCBS-NC INDIV
891263KMedicaidNC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00497NCMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
0101255992VAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis Gale Physicians LLC Past Accepting new patients

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1124040472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "address_2": "SUITE 1310",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-776-2020",
            "fax_number": "540-776-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "address_2": "SUITE 1310",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-776-2020",
            "fax_number": "540-776-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSAIN",
        "first_name": "ALI",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NC",
            "license": "00497",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "VA",
            "license": "0101255992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124040472",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-NC INDIV",
            "identifier": "1263K",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891263K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.