Individual provider Active NPI

Ahmad W Husari, MD

  • Pulmonary Disease Physician
  • Riverside, CA
National Provider Identifier
1407957665
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A49093 Issued in CA
Practice address
7117 Brockton Ave
Riverside, CA 92506-2658
Phone
(951) 784-3045
NPI assigned
Sep 26, 2006
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 17283 WV
Pulmonary Disease Physician 207RP1001X A49093 CA Primary

Addresses

Primary practice location

7117 Brockton Ave
Riverside, CA 92506-2658

Mailing address

400 C Depot St
PO Box 303
Burnsville, WV 26335
Phone (304) 853-2461

Other identifiers 1

IdentifierTypeStateIssuer
0204374000MedicaidWV

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20201231001809 CA Practitioner - Pulmonary Disease 0547170433 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A49093CAMDPulmonary Disease Physician
17283WVMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahmed Husari, MD, Inc CurrentSince Jan 1, 2002 Accepting new patients
Riverside Medical Clinic, Inc Current Accepting new patients
Riverside Medical Clinic, Inc CurrentSince Oct 30, 2020 Accepting new patients
Riverside Medical Clinic, Inc CurrentSince Oct 30, 2020 Accepting new patients
RMC Surgery Center, LLC Past Accepting new patients
Sleep Medicine WV, Inc. Pulmonary Disease PastSince Dec 1, 1999 Accepting new patients
Mountain State Sleep Center, Inc PastSince Sep 12, 2012 Accepting new patients

Locations

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

7160 Brockton Ave
Riverside, CA 92506
Phone (951) 782-3714

21634 Retreat Pkwy
Temescal Valley, CA 92883
Phone (951) 782-5157

809 Mineral Rd
Glenville, WV 26351
Phone (304) 462-5708

1194 Pineview Dr
Morgantown, WV 26505
Phone (304) 439-0447

1194 Pineview Dr
Morgantown, WV 26505
Phone (304) 439-0447

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1407957665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 C DEPOT ST",
            "address_2": "PO BOX 303",
            "city": "BURNSVILLE",
            "state": "WV",
            "postal_code": "26335",
            "telephone_number": "304-853-2461",
            "fax_number": "304-853-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-784-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSARI",
        "first_name": "AHMAD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WV",
            "license": "17283",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A49093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0204374000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.