NPIMap

Individual provider Active NPI

Ousama Ismael, MD

  • Internal Medicine Physician
  • San Bernardino, CA
National Provider Identifier
1740451079
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A100770 Issued in CA
Practice address
1869 N Waterman Ave Ste 200
San Bernardino, CA 92404-4830
Phone
(909) 881-0030
Fax
(909) 881-0040
NPI assigned
Mar 14, 2008
Last updated
Jun 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A100770 CA Primary

Addresses

Primary practice location

1869 N Waterman Ave Ste 200
San Bernardino, CA 92404-4830

Mailing address

12223 Highland Ave
Suite 106, Box 607
Rancho Cucamonga, CA 91739
Phone (909) 996-0333

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
I20110201000184 CA Practitioner - HospitalistPractitioner - Internal Medicine 1759560105 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1869 N Waterman Ave
Suite 200
San Bernardino, CA 92404-4830
Phone (909) 996-0333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians, PC Current Accepting new patients
US Healthcare Inc Internal Medicine CurrentSince Feb 20, 2016 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Feb 1, 2016 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
St Mary Medical Center Inc Past Accepting new patients
Dignity Health Past Accepting new patients
Diagnostic Imaging Services Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients
Neonatology Medical Group Inc Internal Medicine Past Accepting new patients
Victor Valley Community Hospital Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

12223 Highland Ave
Ste 106
Rch Cucamonga, CA 91739
Phone (323) 423-4015

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1869 N Waterman Ave
Ste 200
San Bernardino, CA 92404
Phone (909) 886-6911

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Allied Hospice & Palliative CarePalm Desert, CA, CCN B51707 Hospice Contracted Managing Employee Dec 1, 2023

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 10

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 12

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": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1740451079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12223 HIGHLAND AVE",
            "address_2": "SUITE 106, BOX 607",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91739",
            "telephone_number": "909-996-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1869 N WATERMAN AVE STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044830",
            "telephone_number": "909-881-0030",
            "fax_number": "909-881-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAEL",
        "first_name": "OUSAMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-14",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A100770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.