Individual provider Active NPI

Hina Ansar Hussain, D.O.

  • Emergency Medicine Physician
  • Hollywood, FL
National Provider Identifier
1619231230
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS14141 Issued in FL
Practice address
3501 Johnson St
Hollywood, FL 33021-5421
Phone
(954) 987-2000
NPI assigned
Jun 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101020073 MI
Emergency Medicine Physician 207P00000X OS14141 FL Primary

Addresses

Primary practice location

3501 Johnson St
Hollywood, FL 33021-5421

Mailing address

3501 Johnson St
Hollywood, FL 33021-5421

Other names 1

  • Dr. Hina Ansar Former name

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
I20190522001246 IN Practitioner - Emergency Medicine 0648552836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lincoln Memorial University Medical Department, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Bend Emergency Physicians IncGroup PAC ID 0941282354, 51 clinicians

Practice addresses (Care Compare)

615 N Michigan St
South Bend, IN 46601-1033
Phone (574) 647-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101020073MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Bend Emergency Physicians, Inc Emergency Medicine CurrentSince Jul 15, 2019 Accepting new patients

Locations

1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967

3220 Beacon Pkwy
Granger, IN 46530
Phone (574) 647-8788

615 N Michigan St
Ste Ecc
South Bend, IN 46601

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

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 4

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1619231230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-987-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "HINA",
        "middle_name": "ANSAR",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101020073",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS14141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HINA",
            "last_name": "ANSAR",
            "prefix": "DR.",
            "credential": "D.O",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.