NPIMap

Individual provider Active NPI

Jaffer Hussain, M.D.

  • Internal Medicine Physician
  • Edenton, NC
National Provider Identifier
1699218842
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2020-04427 Issued in NC
Practice address
104 Mark Dr
Edenton, NC 27932-1756
Phone
(252) 482-5171
Fax
(252) 482-5173
NPI assigned
Nov 21, 2016
Last updated
Oct 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 2020-04427 NC
Internal Medicine Physician 207R00000X 2020-04427 NC Primary

Addresses

Primary practice location

104 Mark Dr
Edenton, NC 27932-1756

Mailing address

104 Mark Dr
Edenton, NC 27932-1756
Phone (252) 482-5171

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhussain110775@direct.vidanthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211025001757 NC Practitioner - Internal MedicinePractitioner - Infectious Disease 5991089674 Reassigns benefits to 3 organizations
I20260623000220 VA Practitioner - Critical Care (Intensivists) 5991089674

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

211 Virginia Rd
Edenton, NC 27932-9668
Phone (252) 482-6219

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Health-Bertie CurrentSince Nov 30, 2022 Accepting new patients
Vidant Medical Group LLC CurrentSince Nov 8, 2021 Accepting new patients
East Carolina Health-Bertie CurrentSince Nov 30, 2022 Accepting new patients

Locations

500 Academy St S
Ahoskie, NC 27910
Phone (252) 209-3000

211 Virginia Rd
Edenton, NC 27932
Phone (252) 384-2590

104 Mark Dr
Edenton, NC 27932
Phone (252) 482-5171

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

4800 S Croatan Hwy
Nags Head, NC 27959
Phone (252) 449-4500

1403 S King St
Windsor, NC 27983
Phone (252) 794-6685

Organizations & group practices 4

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 5

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": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1699218842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MARK DR",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279321756",
            "telephone_number": "252-482-5171",
            "fax_number": "252-482-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MARK DR",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279321756",
            "telephone_number": "252-482-5171",
            "fax_number": "252-482-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "JAFFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-21",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NC",
            "license": "2020-04427",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2020-04427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhussain110775@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edenton, NC

Sources for this page

Verify at the official NPI Registry.