Organization Active NPI

Hussein Mazloum MD PC

  • Surgery Physician
  • Flint, MI
National Provider Identifier
1699012450
Registry record updated Jan 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
HM063987 Issued in MI
Legal business name
HUSSEIN MAZLOUM MD PC
Practice address
1020 Charter Dr
Suite a
Flint, MI 48532-3584
Phone
(810) 239-8051
Fax
(810) 239-3925
NPI assigned
Jan 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2013

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

Authorized official

Name
Dr. Hussein Ali Mazloum, M.D.NPI 1356368781
Title
Physician
Phone
(810) 239-8051

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X HM063987 MI Primary
Trauma Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0127X HM063987 MI

Addresses

Primary practice location

1020 Charter Dr
Suite a
Flint, MI 48532-3584

Mailing address

1020 Charter Dr
Suite a
Flint, MI 48532-3584
Phone (810) 239-8051

Other identifiers 1

IdentifierTypeStateIssuer
4356904MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130523000277 MI Part B Supplier - Clinic/Group Practice 7416195979 Receives reassigned benefits from 1 practitioner
Practice locations: Woodhaven, MI

National Provider Directory

National Provider Directory

Locations

25000 Hall Rd
Ste 3
Woodhaven, MI 48183
Phone (734) 445-0455

25000 Hall Rd
Ste 300
Woodhaven, MI 48183
Phone (734) 672-7758

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAAADA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1358035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358035200000",
    "number": "1699012450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 CHARTER DR",
            "address_2": "SUITE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323584",
            "telephone_number": "810-239-8051",
            "fax_number": "810-239-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 CHARTER DR",
            "address_2": "SUITE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323584",
            "telephone_number": "810-239-8051",
            "fax_number": "810-239-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUSSEIN MAZLOUM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-13",
        "last_updated": "2013-01-13",
        "status": "A",
        "authorized_official_last_name": "MAZLOUM",
        "authorized_official_first_name": "HUSSEIN",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "810-239-8051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "HM063987",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "MI",
            "license": "HM063987",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4356904",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.