Individual provider Active NPI

Ismail Umar Husain, DO

  • Internal Medicine Physician
  • Warren, OH
National Provider Identifier
1497115059
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34014644 Issued in OH
Practice address
349 Niles Cortland Rd NE
Warren, OH 44484-1976
Phone
(330) 372-0260
Fax
(330) 372-0261
NPI assigned
Feb 25, 2016
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X SS929978 OH
Internal Medicine Physician 207R00000X 34014644 OH Primary

Addresses

Primary practice location

349 Niles Cortland Rd NE
Warren, OH 44484-1976

Mailing address

349 Niles Cortland Rd NE
Warren, OH 44484-1976
Phone (330) 372-0260

Other identifiers 1

IdentifierTypeStateIssuer
0336526MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200929000890 OH Practitioner - Internal Medicine 4789003500 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert E Bisel DO and Associates LLCGroup PAC ID 4486700267, 4 clinicians

Practice addresses (Care Compare)

667 Eastland Ave SE
Warren, OH 44484-4503
Phone (330) 841-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34014644OHMDInternal Medicine Physician
SS929978OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert E. Bisel, DO & Associates, LLC Internal Medicine CurrentSince Oct 13, 2020 Accepting new patients
Dr Larry Woods Inc PastSince May 1, 2020 Accepting new patients

Locations

349 Niles Cortland Rd NE
Warren, OH 44484
Phone (330) 372-0260

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

667 Eastland Ave SE
Fl 5
Warren, OH 44484
Phone (330) 841-4750

8600 E Market St
Ste 8
Warren, OH 44484
Phone (330) 372-0260

Interoperability endpoints

  • Direct secure messaging: ihusain224607@direct.bsmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1497115059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841976",
            "telephone_number": "330-372-0260",
            "fax_number": "330-372-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841976",
            "telephone_number": "330-372-0260",
            "fax_number": "330-372-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSAIN",
        "first_name": "ISMAIL",
        "middle_name": "UMAR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-25",
        "last_updated": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "SS929978",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34014644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0336526",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.