Individual provider Active NPI

Hadiya Hussaini

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1184359762
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1153490 Issued in TX
Practice address
4844 Greenville Ave
Dallas, TX 75206-4120
Phone
(214) 295-9410
NPI assigned
Jul 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.025344 IL
Family Nurse Practitioner 363LF0000X APRN21017493 FL
Family Nurse Practitioner 363LF0000X 1153490 TX Primary

Addresses

Primary practice location

4844 Greenville Ave
Dallas, TX 75206-4120

Mailing address

6000 Columbus Ave Apt 1204
Plano, TX 75024-6164
Phone (954) 610-4550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221005003045 IL Practitioner - Nurse Practitioner 7416333034 Reassigns benefits to 2 organizations
I20241026000332 TX Practitioner - Nurse Practitioner 7416333034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John Allen Van Wagoner, MD, PAGroup PAC ID 9335273390, 9 clinicians

Practice addresses (Care Compare)

6100 Windcom CT
Suite 101
Plano, TX 75093-7887
Phone (972) 398-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN21017493FLMDFamily Nurse Practitioner
209.025344ILMDFamily Nurse Practitioner
1153490TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John Allen Van Wagoner, MD, PA CurrentSince May 5, 2025 Accepting new patients
Physicians Immediate Care North Chicago LLC CurrentSince Jan 23, 2023 Accepting new patients

Locations

600 W Adams St
Chicago, IL 60661
Phone (312) 506-0900

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

1009 Fairway Dr
Freeport, IL 61032
Phone (815) 986-4200

5012 S US Highway 75
Ste 150
Denison, TX 75020
Phone (903) 463-8400

6100 Windcom Ct
Ste 101
Plano, TX 75093
Phone (972) 398-3500

Organizations & group practices 3

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": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1184359762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 COLUMBUS AVE APT 1204",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750246164",
            "telephone_number": "954-610-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4844 GREENVILLE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064120",
            "telephone_number": "214-295-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAINI",
        "first_name": "HADIYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.025344",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN21017493",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1153490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.