NPIMap

Individual provider Active NPI

Husam S. Kaileh, M.D.

  • Family Medicine Physician
  • San Joaquin, CA
National Provider Identifier
1700920899
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A52444 Issued in CA
Practice address
21890 W. Colorado Avenue
San Joaquin, CA 93660
Phone
(559) 693-2462
Fax
(559) 693-4382
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A52444 CA Primary

Addresses

Primary practice location

21890 W. Colorado Avenue
San Joaquin, CA 93660

Mailing address

PO Box 737
San Joaquin, CA 93660-0737
Phone (559) 693-2462

Other identifiers 1

IdentifierTypeStateIssuer
FHC03875FMedicaidCA

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
I20240813003969 CA Practitioner - Family Practice 2365698545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Health Team, Inc.Group PAC ID 2365588902, 14 clinicians

Practice addresses (Care Compare)

21890 W Colorado Ave
San Joaquin, CA 93660-9773
Phone (559) 693-2462

Hospital & facility affiliations

  • Compassionate Care Home Health Agency, LLC Home health agency, Fresno, CA, CCN 058233
  • Kure Home Health Home health agency, Clovis, CA, CCN 559543

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Health Team, Inc. Current Accepting new patients
Valley Health Team Inc CurrentSince Jun 30, 2024 Accepting new patients
Valley Health Team, Inc. Family Medicine Current Accepting new patients
Valley Health Team, Inc CurrentSince Jun 30, 2024 Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Valley Health Team, Inc Family Medicine Past Accepting new patients

Locations

689 N St
Firebaugh, CA 93622
Phone (559) 659-3037

449 S Madera Ave
Kerman, CA 93630
Phone (559) 364-2970

21890 W Colorado Ave
San Joaquin, CA 93660
Phone (559) 693-2462

Interoperability endpoints

  • Direct secure messaging: husam.kaileh.p4@direct.vht.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
San Joaquin Health CenterSan Joaquin, CA, CCN 051937 Federally qualified health center Corporate Officer Aug 1, 1995
Kerman Health CenterKerman, CA, CCN 551847 Federally qualified health center Corporate Officer Aug 1, 1995
Firebaugh Community Health CenterFirebaugh, CA, CCN 551176 Federally qualified health center Corporate Officer Jan 20, 2011
Kerman Unified School District Community Health CenterKerman, CA, CCN 751043 Federally qualified health center Corporate Officer Aug 1, 1995
Clovis Community Health CenterClovis, CA, CCN 751087 Federally qualified health center Corporate Officer Aug 1, 1995
Kingsburg Community Health CenterKingsburg, CA, CCN 751894 Federally qualified health center Corporate Officer Aug 1, 1995
Central Fresno Community Health CenterFresno, CA, CCN 921042 Federally qualified health center Corporate Officer Aug 1, 1995
Dinuba Community Health CenterDinuba, CA, CCN 921129 Federally qualified health center Corporate Officer Aug 1, 1995
Kerman Dental Center / Valley Optometric CenterKerman, CA, CCN 921879 Federally qualified health center Corporate Officer Aug 1, 1995
Valley Health Team, Inc.Bishop, CA, CCN 921958 Federally qualified health center Corporate Officer Aug 1, 1995

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1700920899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 737",
            "city": "SAN JOAQUIN",
            "state": "CA",
            "postal_code": "936600737",
            "telephone_number": "559-693-2462",
            "fax_number": "559-693-4382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21890 W. COLORADO AVENUE",
            "city": "SAN JOAQUIN",
            "state": "CA",
            "postal_code": "93660",
            "telephone_number": "559-693-2462",
            "fax_number": "559-693-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAILEH",
        "first_name": "HUSAM",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A52444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC03875F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Joaquin, CA

Sources for this page

Verify at the official NPI Registry.