NPIMap

Individual provider Active NPI

Husam Ghusn, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Missouri City, TX
National Provider Identifier
1871585588
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036169067 Issued in IL
Practice address
3803 FM 1092 Rd
Missouri City, TX 77459-2209
Phone
(281) 403-8271
Fax
(281) 403-8274
NPI assigned
Aug 18, 2005
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036169067 IL Primary
Emergency Medicine Physician 207P00000X H5171 TX

Addresses

Primary practice location

3803 FM 1092 Rd
Missouri City, TX 77459-2209

Mailing address

1211 Highway 6
Suite 1
Sugar Land, TX 77478-4941
Phone (281) 494-4832

Other identifiers 1

IdentifierTypeStateIssuer
137392005MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240318001151 IL Practitioner - EndocrinologyPractitioner - Internal Medicine 8921054669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Mar 5, 2024 Accepting new patients
Greater Texas Emergency Consultants, P.a. Emergency Medicine Past Accepting new patients
Osf Multispecialty Group - Eastern Region, LLC Past Accepting new patients
Memorial Hospital of Polk County PastSince Jan 1, 2002 Accepting new patients
Texas Emergency Room Services PA Emergency Medicine Past Accepting new patients
Camino Real Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

1800 N Knoxville Ave
Ste E
Peoria, IL 61603
Phone (309) 308-0910

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 7

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 4

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1871585588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 HIGHWAY 6",
            "address_2": "SUITE 1",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784941",
            "telephone_number": "281-494-4832",
            "fax_number": "281-494-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 FM 1092 RD",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592209",
            "telephone_number": "281-403-8271",
            "fax_number": "281-403-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHUSN",
        "first_name": "HUSAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036169067",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "H5171",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137392005",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.