Individual provider Active NPI

Tarik Ahmed Hussein, M.D.

  • Internal Medicine Physician
  • Hemet, CA
National Provider Identifier
1427410984
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A160228 Issued in CA
Practice address
1117 E Devonshire Ave
Hemet, CA 92543-3083
Phone
(951) 652-2811
NPI assigned
Mar 24, 2016
Last updated
Jan 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A160228 CA Primary

Addresses

Primary practice location

1117 E Devonshire Ave
Hemet, CA 92543-3083

Mailing address

35100 Mahogany Glen Dr
Winchester, CA 92596-8264
Phone (619) 715-3182

Other practice location 1

1155 Mill St # W11
Reno, NV 89502-1576
Phone (775) 327-5174

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200129001619 CA Practitioner - Hospitalist 8820383888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A160228CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Star Hospital Associates Inc. CurrentSince Apr 1, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 7, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 7, 2022 Accepting new patients
Seven Star Hospital Associates Inc. CurrentSince Apr 1, 2021 Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

1117 E Devonshire Ave
Hemet, CA 92543
Phone (951) 652-2811

393 E Walnut St
#5
Pasadena, CA 91188

Organizations & group practices 5

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 1

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1427410984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35100 MAHOGANY GLEN DR",
            "city": "WINCHESTER",
            "state": "CA",
            "postal_code": "925968264",
            "telephone_number": "619-715-3182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 E DEVONSHIRE AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433083",
            "telephone_number": "951-652-2811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 Mill St # W11",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021576",
            "country_code": "US",
            "telephone_number": "775-327-5174",
            "fax_number": "775-327-5178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUSSEIN",
        "first_name": "TARIK",
        "middle_name": "AHMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2023-01-13",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A160228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.