NPIMap

Individual provider Active NPI

Hussein Othman, M.D

  • Cardiovascular Disease Physician
  • Jackson, MI
National Provider Identifier
1306089040
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301091824 Issued in MI
Practice address
205 Page Ave Ste B
Jackson, MI 49201-2462
Phone
(517) 787-3577
NPI assigned
Apr 10, 2009
Last updated
Jun 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5315035401 MI
Cardiovascular Disease Physician 207RC0000X 4301091824 MI Primary

Addresses

Primary practice location

205 Page Ave Ste B
Jackson, MI 49201-2462

Mailing address

205 Page Ave Ste B
Jackson, MI 49201-2462
Phone (517) 787-3577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110728000292 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional CardiologyPractitioner - Internal Medicine 3678741162 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Cardiology Consultants PLLCGroup PAC ID 0042545535, 8 clinicians

Practice addresses (Care Compare)

205 N E Ave
Jackson, MI 49201-1753
Phone (517) 205-4800

205 Page Ave
Suite B
Jackson, MI 49201-2462
Phone (517) 787-3577

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5315035401MIMDInternal Medicine Physician
4301091824MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Cardiology Consultants PLLC CurrentSince Jul 2, 2019 Accepting new patients
Cardiovascular Institute of Michigan, P.C. Cardiovascular Disease CurrentSince Jul 1, 2016 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Apr 1, 2020 Accepting new patients
W.a. Foote Memorial Hospital, Inc Cardiovascular Disease CurrentSince Apr 1, 2020 Accepting new patients
W. a. Foote Memorial Hospital, Inc Internal Medicine Current Accepting new patients
Jackson Cardiology & Associates Cardiovascular Disease CurrentSince Sep 12, 2018 Accepting new patients
Preventive Cardiovascular Institute PLLC Cardiovascular Disease PastSince Jul 1, 2016 Accepting new patients

Locations

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

205 Page Ave
Ste A
Jackson, MI 49201
Phone (517) 787-3577

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

1701 Lake Lansing Rd
Ste 100
Lansing, MI 48912
Phone (517) 485-9676

18303 E 10 Mile Rd
Ste 100
Roseville, MI 48066
Phone (586) 776-8877

Interoperability endpoints

  • Direct secure messaging: hothman236227@direct.hfhs.org

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1306089040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PAGE AVE STE B",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012462",
            "telephone_number": "517-787-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PAGE AVE STE B",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012462",
            "telephone_number": "517-787-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTHMAN",
        "first_name": "HUSSEIN",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-10",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5315035401",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301091824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.