Individual provider Active NPI

Hussein Ebro Waliye, M.D.

  • Surgical Critical Care Physician
  • Saint Louis, MO
National Provider Identifier
1881009256
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
2019024497 Issued in MO
Practice address
10012 Kennerly Rd Ste 406
Saint Louis, MO 63128-2197
Phone
(314) 525-1224
NPI assigned
Jun 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 2019024497 MO Primary
Surgery Physician 208600000X 2019024497 MO

Addresses

Primary practice location

10012 Kennerly Rd Ste 406
Saint Louis, MO 63128-2197

Mailing address

10012 Kennerly Rd Ste 406
Saint Louis, MO 63128-2197
Phone (314) 525-1224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200430000895 MO Practitioner - General Surgery 6901022409 Reassigns benefits to 3 organizations
I20251125000177 WI Practitioner - General Surgery 6901022409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians
Mercy Clinic Surgical Specialists LLCGroup PAC ID 1153455076, 180 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

10012 Kennerly Rd
Suite 406
Saint Louis, MO 63128-2197
Phone (314) 525-1224

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019024497MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Surgical Specialists, LLC Surgery CurrentSince Sep 11, 2023 Accepting new patients
Mercy Clinic Trauma and General Surgery, LLC CurrentSince Jun 28, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Sep 22, 2025 Accepting new patients
Urgent Specialty Associates of Missouri LLC Surgical Critical Care CurrentSince Mar 7, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Sep 22, 2025 Accepting new patients
Mercy Hospital South Past Accepting new patients
Mercy Clinic East Communities Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

10012 Kennerly Rd
Ste 406
Saint Louis, MO 63128
Phone (314) 525-1224

621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070

621 S New Ballas Rd
Ste 560A
Saint Louis, MO 63141
Phone (314) 251-6440

851 E 5th St
Ste 108
Washington, MO 63090
Phone (636) 239-4144

3400 Deerfield Dr
Janesville, WI 53546
Phone (608) 314-3600

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

Interoperability endpoints

  • Direct secure messaging: husseinwaliye@mhccaremail.com

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 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": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1881009256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 406",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 406",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALIYE",
        "first_name": "HUSSEIN",
        "middle_name": "EBRO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MO",
            "license": "2019024497",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2019024497",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.