NPIMap

Individual provider Active NPI

Samuel Houssam Mardini, MD

  • Gastroenterology Physician
  • Lexington, KY
National Provider Identifier
1780622761
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
37438 Issued in KY
Practice address
1401 Harrodsburg Rd Ste C305
Lexington, KY 40504-3771
Phone
(859) 278-8400
Fax
(859) 276-3700
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 24021 WV
Gastroenterology Physician 207RG0100X 24021 WV
Gastroenterology Physician 207RG0100X 37438 KY Primary

Addresses

Primary practice location

1401 Harrodsburg Rd Ste C305
Lexington, KY 40504-3771

Mailing address

PO Box 936
London, KY 40743-0936
Phone (606) 330-7835

Other identifiers 1

IdentifierTypeStateIssuer
64108053MedicaidKY

Other names 1

  • Dr. Houssam Eddin Mardini Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, SC2 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
I20050628000125 KY Practitioner - GastroenterologyPractitioner - Internal MedicinePractitioner - Emergency Medicine 4688619802 Reassigns benefits to 1 organization
I20110727000213 SC Practitioner - GastroenterologyPractitioner - Internal Medicine 4688619802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Joseph Dr
Lexington, KY 40504-3742
Phone (859) 313-1000

1401 Harrodsburg Rd
Lexington, KY 40504-3751
Phone (859) 276-4429

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

305 Estill St
Berea, KY 40403-1742
Phone (859) 986-8418

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux221

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Internal Medicine CurrentSince Jun 16, 2025 Accepting new patients
Kentucky Medical Services Foundation, Inc Internal Medicine CurrentSince Nov 22, 2013 Accepting new patients
University Medical Associates of the Medical University of South Carol Gastroenterology Current Accepting new patients
JMHC Inc Past Accepting new patients
Uhhs Bedford Internal Medicine Past Accepting new patients

Locations

2325 Concrete Rd
Carlisle, KY 40311
Phone (859) 289-7181

800 Rose St
#654
Lexington, KY 40536
Phone (859) 323-0079

800 Rose St
#651
Lexington, KY 40536

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: smardini20874@ukhcdirect.org
  • Direct secure messaging: smardini534951@direct.musc.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1780622761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-7835",
            "fax_number": "859-278-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD STE C305",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043771",
            "telephone_number": "859-278-8400",
            "fax_number": "859-276-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDINI",
        "first_name": "SAMUEL",
        "middle_name": "HOUSSAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "24021",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WV",
            "license": "24021",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "37438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64108053",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOUSSAM",
            "last_name": "MARDINI",
            "middle_name": "EDDIN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.