Individual provider Active NPI

Hossam A El Refaie

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1386817138
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
11912 Elm St
Suite 106
Omaha, NE 68144-4443
Phone
(402) 630-9756
Fax
(402) 504-3535
NPI assigned
Apr 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

11912 Elm St
Suite 106
Omaha, NE 68144-4443

Mailing address

14440 F St
Ste 103
Omaha, NE 68137-1005
Phone (402) 630-9756

Other identifiers 1

IdentifierTypeStateIssuer
10025105700MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080623000186 NE Practitioner - Physical Therapist in Private Practice 4880608108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14440 F St
Suite 103
Omaha, NE 68137-1005
Phone (402) 504-3535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1261NEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
East & West Physical Therapy LLC CurrentSince Jan 1, 2003 Accepting new patients
Matthew D. Skaff DC, PC Past Accepting new patients

Locations

2919 S 120th St
Omaha, NE 68144
Phone (402) 330-2510

11912 Elm St
Ste 106
Omaha, NE 68144
Phone (402) 630-9756

14440 F St
Ste 103
Omaha, NE 68137
Phone (402) 504-3535

Organizations & group practices 2

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": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1386817138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14440 F ST",
            "address_2": "STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371005",
            "telephone_number": "402-630-9756",
            "fax_number": "402-504-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11912 ELM ST",
            "address_2": "SUITE 106",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444443",
            "telephone_number": "402-630-9756",
            "fax_number": "402-504-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL REFAIE",
        "first_name": "HOSSAM",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025105700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.