Individual provider Active NPI

Hisham Hussan, M.D.

  • Gastroenterology Physician
  • Sacramento, CA
National Provider Identifier
1801044789
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
179407 Issued in CA
Practice address
3160 Folsom Blvd Ste 3500
Sacramento, CA 95816-5270
Phone
(916) 734-3759
NPI assigned
Sep 3, 2008
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 35123753 OH
Gastroenterology Physician 207RG0100X 179407 CA Primary

Addresses

Primary practice location

3160 Folsom Blvd Ste 3500
Sacramento, CA 95816-5270

Mailing address

3160 Folsom Blvd Ste 3500
Sacramento, CA 95816-5270
Phone (916) 734-3759

Other identifiers 1

IdentifierTypeStateIssuer
0107158MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address hhussan249733@direct.osumc.edu
Direct Messaging Address hhussan249733@direct.osumc.edu Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221202001584 CA Practitioner - Gastroenterology 9133347685 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

4860 Y St
Sacramento, CA 95817-2307
Phone (916) 734-8306

550 W Ranch View Dr
Rocklin, CA 95765-5396
Phone (916) 295-5766

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy98
Upper gastrointestinal (GI) endoscopy for acid reflux62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179407CAMDGastroenterology Physician
35123753OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca Gastroenterology CurrentSince Nov 1, 2022 Accepting new patients
Regents of the University of California CurrentSince Nov 2, 2023 Accepting new patients
Regents of the Univ of Ca CurrentSince Nov 1, 2022 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince Nov 2, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Essent PRMC LP Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2440 W Covell Blvd
Ste 104
Davis, CA 95616
Phone (530) 747-3000

2660 W Covell Blvd
Davis, CA 95616
Phone (530) 747-3000

8110 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3955

271 Turn Pike Dr
Folsom, CA 95630
Phone (916) 985-9200

10850 White Rock Rd
Rancho Cordova, CA 95670

550 W Ranch View Dr
Rocklin, CA 95765
Phone (916) 295-5700

2400 Del Paso Rd
Ste 145
Sacramento, CA 95834
Phone (916) 928-3940

3160 Folsom Blvd
Ste 3500
Sacramento, CA 95816
Phone (916) 734-0779

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

Interoperability endpoints

  • Direct secure messaging: hhussan249733@direct.osumc.edu

Organizations & group practices 11

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 1

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1801044789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 FOLSOM BLVD STE 3500",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165270",
            "telephone_number": "916-734-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 FOLSOM BLVD STE 3500",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165270",
            "telephone_number": "916-734-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAN",
        "first_name": "HISHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35123753",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "179407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107158",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hhussan249733@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "410 W 10th Ave",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432101240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hhussan249733@direct.osumc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2050 Kenny Rd Fl Tower",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432213502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.