NPIMap

Individual provider Active NPI

Hussain Al-Darsani, M.D.

  • Gastroenterology Physician
  • Chino, CA
National Provider Identifier
1669429775
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A68782 Issued in CA
Practice address
5562 Philadelphia St Ste 203
Chino, CA 91710-2482
Phone
(909) 287-0440
Fax
(909) 287-0145
NPI assigned
May 27, 2006
Last updated
Jul 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A68782 CA Primary

Addresses

Primary practice location

5562 Philadelphia St Ste 203
Chino, CA 91710-2482

Mailing address

5562 Philadelphia St Ste 203
Chino, CA 91710-2482
Phone (909) 287-0440

Other identifiers 3

IdentifierTypeStateIssuer
743237905OtherCAIRS
00A6768210MedicaidCA
00A6878210MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019001010 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 6507882446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5562 Philadelphia St
Suite 203
Chino, CA 91710-2482
Phone (909) 287-0440

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy91
Upper gastrointestinal (GI) endoscopy for acid reflux107

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68782CAMDPharmacist
A68782CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hussain Al-Darsani a Professional Corp Internal Medicine Current Accepting new patients
Hussain Al-Darsani M.D. a Professional Corporation Gastroenterology CurrentSince May 19, 2009 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Tiffany Anderson Terrell, DO. Inc Past Accepting new patients
Primecare Medical Group Internal Medicine Past Accepting new patients
Brian J. Loveless, DO, Inc Past Accepting new patients

Locations

13193 Central Ave
Ste 110
Chino, CA 91710
Phone (909) 591-6227

5562 Philadelphia St
Ste 203
Chino, CA 91710
Phone (909) 287-0440

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/JEFABD

Organizations & group practices 6

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 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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1669429775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5562 PHILADELPHIA ST STE 203",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102482",
            "telephone_number": "909-287-0440",
            "fax_number": "909-287-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5562 PHILADELPHIA ST STE 203",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102482",
            "telephone_number": "909-287-0440",
            "fax_number": "909-287-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-DARSANI",
        "first_name": "HUSSAIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A68782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "743237905",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A6768210",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A6878210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.