Hussam Aldeen Jefee Bahloul, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

261950 Issued in MA

Practice address

55 Lake Ave N
Worcester, MA 01655-0002

Phone

(508) 856-2148

Fax

(508) 856-5990

NPI assigned

Aug 4, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Psychiatry

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Pratt Psychiatric Associates IncGroup PAC ID 8921999525, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
• Tufts Medical Center Hospital, Boston, MA, CCN 220116

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

82.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hjefeebahloul22952@umassmemorial.direct-ci.com

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.

• Pratt Psychiatric Associates, Inc

  • Psychiatry Physician
  • Boston, MA
  • NPI 1245270875
  Medicare reassignment Care Compare group NPD
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Umass Memorial Medical Group, Inc.

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tufts Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1730132515
  Care Compare affiliation
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606608000000",
    "number": "1669603957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-856-2148",
            "fax_number": "508-856-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFEE BAHLOUL",
        "first_name": "HUSSAM ALDEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2020-11-29",
        "certification_date": "2020-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "051858",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CT",
            "license": "051858",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "261950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110103661A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DR. BAHLOUL",
            "identifier": "D400160566",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DR. BAHLOUL",
            "identifier": "008050854",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hjefeebahloul22952@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Loane Jean
• Theodora Jean, RN
• Jeana-Marie Allan, Psy.D., PLLC
• Scott Jeannes, M.D.
• Marie G Jeanty
• Nicole Marie Jeff
• Mary B. Jeffers-Terry, RN,PC
• Jill Ann Jeffers, MA, LSW
• Jeffrey J. Davis, D.D.S.,P.C.
• Carolyn Jeffries, PA-C

• Psychiatry Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2020; 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.

Verify at the official NPI Registry.