Mazen Khusayem, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9900898 Issued in NC

Practice address

301 Amos St
Clayton, NC 27520-2644

Phone

(919) 550-6336

Fax

(919) 550-0180

NPI assigned

Jan 25, 2006

Last updated

Aug 6, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Internal Medicine

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medi Home Health Agency Home health agency, Raleigh, NC, CCN 347237
• Well Care Home Health of the Southern Triangle, Inc. Home health agency, Holly Springs, NC, CCN 347336
• Johnston Health Hospital, Smithfield, NC, CCN 340090

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mazenkhusayem@cimpc.allscriptsdirect.net

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.

• Clayton Internal Medicine PC

  • Medical Specialty Clinic/Center
  • Clayton, NC
  • NPI 1366658833
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Johnston Health Services Corporation

  dba Johnston Health

  • General Acute Care Hospital
  • Smithfield, NC
  • NPI 1619911104
  Care Compare affiliation
• Medical Services of America, Inc.

  dba Medi Home Health Agency

  • Home Health Agency
  • Raleigh, NC
  • NPI 1942252853
  Care Compare affiliation
• Well Care Home Health of the Southern Triangle, Inc.

  • Home Health Agency
  • Holly Springs, NC
  • NPI 1508418005
  Care Compare affiliation

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1285604934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 997",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275280997",
            "telephone_number": "919-550-6336",
            "fax_number": "919-550-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 AMOS ST",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202644",
            "telephone_number": "919-550-6336",
            "fax_number": "919-550-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHUSAYEM",
        "first_name": "MAZEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9900898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126XV",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Catherine Kelly, M.ED, NBCT
• Emily Kelly, CD (DONA), HCHD
• Sheila Kelly, LCSWA
• Krista Nikia Khalik, PMHNP-BC, MSN, RN
• Michael Maher Fahmy Khalil
• Kidcom, L.L.C.
• Kids R US Therapy
• Kidscare Psychological Services, PLLC
• Bo-Kyung Kim, PA-C
• Benee Allen King, AUD

• Internal Medicine Physician in Clayton, NC
• Providers in Clayton, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.