Individual provider Active NPI

Omar Husseini, M.D.

  • Cardiovascular Disease Physician
  • Munster, IN
National Provider Identifier
1467740894
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01079973A Issued in IN
Practice address
9104 Columbia Ave
Munster, IN 46321
Phone
(219) 836-4773
NPI assigned
Jul 19, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036134453 IL
Hospitalist Physician 208M00000X 036134453 IL
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 01079973A IN Primary

Addresses

Primary practice location

9104 Columbia Ave
Munster, IN 46321

Mailing address

9104 Columbia Ave
Munster, IN 46321-2907
Phone (219) 836-4773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180714000131 IN Practitioner - Cardiovascular Disease (Cardiology) 3971827841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

10215 Broadway
Crown Point, IN 46307-8001

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-7005

7651 Harvest Dr
Schererville, IN 46375-3476
Phone (219) 322-5723

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-4563

9104 Columbia Ave
Munster, IN 46321-2907
Phone (219) 836-4473

9120 Columbia Ave
Munster, IN 46321-2907
Phone (219) 703-5301

9122 Columbia Ave
Munster, IN 46321-2907
Phone (219) 836-3366

9124 A Columbia Ave
Munster, IN 46321-2907
Phone (219) 440-7025

9124 Columbia Ave
Suite B
Munster, IN 46321-2907
Phone (219) 836-0445

9126 Columbia Ave
Munster, IN 46321-2907
Phone (219) 703-2408

9130 Columbia Ave
Munster, IN 46321-2932

9660 Wicker Ave
Saint John, IN 46373-9487

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01079973AINMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Single Specialty CurrentSince Jul 1, 2018 Accepting new patients

Locations

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

9104 Columbia Ave
Munster, IN 46321
Phone (219) 836-4473

Interoperability endpoints

  • Direct secure messaging: ohusseini90529@ssdirect.comhs.org

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1467740894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9104 COLUMBIA AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212907",
            "telephone_number": "219-836-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 COLUMBIA AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "46321",
            "telephone_number": "219-836-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSEINI",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036134453",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036134453",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01079973A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.