Individual provider Active NPI

Abid Hussain, M.D.

  • Pediatrics Physician
  • Mayfield, KY
National Provider Identifier
1164620340
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
41115 Issued in KY
Practice address
417 S 6TH St
Mayfield, KY 42066-2311
Phone
(270) 247-1104
Fax
(270) 247-1107
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 41115 KY Primary

Addresses

Primary practice location

417 S 6TH St
Mayfield, KY 42066-2311

Mailing address

417 S 6TH St
Mayfield, KY 42066-2311
Phone (270) 247-1104

Other identifiers 1

IdentifierTypeStateIssuer
41115OtherKYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20080814000313 KY Practitioner - Pediatric Medicine 4284709973 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinelake Physician Practice, LLC CurrentSince Nov 8, 2019 Accepting new patients
Pinelake Physician Practice, LLC CurrentSince Nov 8, 2019 Accepting new patients
Pinelake Physician Practice, LLC Current Accepting new patients
Pinelake Regional Hospital LLC Pediatrics Past Accepting new patients
Morgan-Haugh Professional Services Corporation Pediatrics Past Accepting new patients

Locations

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

417 S 6th St
Ste 1
Mayfield, KY 42066

417 S 6th St
Mayfield, KY 42066
Phone (270) 247-1104

1029 Medical Center Cir
Ste 401
Mayfield, KY 42066
Phone (270) 251-4590

1111 Medical Center Cir
Mayfield, KY 42066
Phone (270) 247-8100

417 S 6th St
Bldg 1
Mayfield, KY 42066

Interoperability endpoints

  • Direct secure messaging: abid.hussain.1@19475.direct.athenahealth.com

Organizations & group practices 5

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1164620340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 S 6TH ST",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420662311",
            "telephone_number": "270-247-1104",
            "fax_number": "270-247-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 S 6TH ST",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420662311",
            "telephone_number": "270-247-1104",
            "fax_number": "270-247-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "ABID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "41115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "41115",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield, KY

Sources for this page

Verify at the official NPI Registry.