Individual provider Active NPI

Hossam Eldine Kamal Youssef, PHYSICAL THERAPIST

  • Physical Therapist
  • Fort Wayne, IN
National Provider Identifier
1225581945
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5844 Townhouse Dr
Fort Wayne, IN 46804-4205
Phone
(260) 600-8825
NPI assigned
Jul 28, 2016
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 05003265A
Home Health Agency 251E00000X 05003265A IN
Physical Therapist 225100000X Primary

Addresses

Primary practice location

5844 Townhouse Dr
Fort Wayne, IN 46804-4205

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

7230 Engle Rd Ste 303
Fort Wayne, IN 46804-2227
Phone (260) 602-6625

Other practice location 2

1883 S US Highway 231
Crawfordsville, IN 47933-9424
Phone (765) 225-2210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190716001919 IN Practitioner - Physical Therapist in Private Practice 3072552967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.79 of 100Reported as group
Quality
90
Improvement activities
40
Cost
30.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Apr 24, 2023 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Apr 24, 2023 Accepting new patients
Therapy on Wheels, Inc. Physical Therapist CurrentSince Sep 24, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

1883 S US Highway 231
Crawfordsville, IN 47933
Phone (765) 225-2210

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1225581945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5844 TOWNHOUSE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044205",
            "telephone_number": "260-600-8825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7230 Engle Rd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468042227",
            "country_code": "US",
            "telephone_number": "260-602-6625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1883 S US Highway 231",
            "address_purpose": "LOCATION",
            "city": "Crawfordsville",
            "state": "IN",
            "postal_code": "479339424",
            "country_code": "US",
            "telephone_number": "765-225-2210",
            "fax_number": "765-225-2264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUSSEF",
        "first_name": "HOSSAM",
        "middle_name": "ELDINE KAMAL",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-28",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": "05003265A",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "05003265A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.