Active NPI
Mahmoud Hassouba, MD
- Plastic and Reconstructive Surgery Physician
- Memphis, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 63540
- Practice address
- 1068 Cresthaven Rd Ste 500
Memphis, TN 38119-0846 - Phone
- (901) 866-8525
- Fax
- (901) 302-2525
- NPI assigned
- Jul 29, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 63540 | TN | |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 63540 | TN | Primary |
Addresses
Primary practice location
1068 Cresthaven Rd Ste 500
Memphis, TN 38119-0846
Mailing address
1068 Cresthaven Rd Ste 300
Memphis, TN 38119-0809
Phone (901) 866-8864
Other practice location 1
262 Danny Thomas Pl
Memphis, TN 38105-3678
Phone (901) 595-3300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Plastic and Reconstructive Surgery
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 866-8053
Hospital & facility affiliations
- Regional One Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.15 of 100
- Quality
- 59.97
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 80.93
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63540 | TN | MD | Plastic and Reconstructive Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Jude Children'S Research Hospital, Inc. | Current | Accepting new patients | |
| Ut Medical Group, Inc. | Current | Accepting new patients | |
| Ut Medical Group Inc | Plastic and Reconstructive Surgery | Current | Accepting new patients |
Locations
1068 Cresthaven Rd
Ste 300
Memphis, TN 38119
Phone (901) 683-0024
1407 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 866-8360
262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343
1068 Cresthaven Rd
Ste 500
Memphis, TN 38119
Phone (901) 476-2727
930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650
877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893
Interoperability endpoints
- mhassouba45313@mlh.direct-ci.com
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Memphis, TN
- NPI 1780676650
Plastic and Reconstructive Surgery
-
- Pediatrics Physician
- Memphis, TN
- NPI 1306335088
-
- Ophthalmology Physician
- Memphis, TN
- NPI 1326919200
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1144213117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742947200000",
"number": "1437534682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1068 CRESTHAVEN RD STE 300",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381190809",
"telephone_number": "901-866-8864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1068 CRESTHAVEN RD STE 500",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381190846",
"telephone_number": "901-866-8525",
"fax_number": "901-302-2525"
}
],
"practiceLocations": [
{
"address_1": "262 Danny Thomas Pl",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381053678",
"country_code": "US",
"telephone_number": "901-595-3300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HASSOUBA",
"first_name": "MAHMOUD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-29",
"last_updated": "2025-03-26",
"certification_date": "2025-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "TN",
"license": "63540",
"primary": false
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "TN",
"license": "63540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.