NPIMap

Individual provider Active NPI

Hassan Mohamed Hussain, MD

  • Cardiovascular Disease Physician
  • Modesto, CA
National Provider Identifier
1962485938
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G70661 Issued in CA
Practice address
3621 Forest Glenn Dr
Modesto, CA 95355-1339
Phone
(209) 521-9661
Fax
(209) 521-9307
NPI assigned
Nov 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G70661 CA Primary

Addresses

Primary practice location

3621 Forest Glenn Dr
Modesto, CA 95355-1339

Mailing address

3621 Forest Glenn Dr
Modesto, CA 95355-1339
Phone (209) 521-9661

Other identifiers 1

IdentifierTypeStateIssuer
1902828841MedicaidCA

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
I20100804000838 CA Practitioner - Cardiovascular Disease (Cardiology) 6709812548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Medical College of Wisconsin, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanislaus Cardiology GroupGroup PAC ID 2264468008, 6 clinicians

Practice addresses (Care Compare)

3621 Forest Glenn Dr
Modesto, CA 95355-1339
Phone (209) 521-9661

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
85.26
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting11
Pacemaker insertion or repair13
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G70661CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanislaus Cardiology Group CurrentSince Jun 17, 2010 Accepting new patients
Summit Surgery Center Modesto, Inc Cardiovascular Disease CurrentSince Jul 19, 2019 Accepting new patients
Rideout Memorial Hospital Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Emanuel Medical Center, Inc. Past Accepting new patients

Locations

654 Lyell Dr
Ste A
Modesto, CA 95356
Phone (209) 521-9661

3621 Forest Glenn Dr
Modesto, CA 95355
Phone (209) 521-7411

1401 Spanos Ct
Ste 230
Modesto, CA 95355
Phone (209) 521-9661

654 Lyell Dr
Ste B
Modesto, CA 95356
Phone (209) 521-9661

Interoperability endpoints

  • Direct secure messaging: hussain@stancard.gwaydirect.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1022

Organizations & group practices 5

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1962485938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 FOREST GLENN DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551339",
            "telephone_number": "209-521-9661",
            "fax_number": "209-521-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 FOREST GLENN DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551339",
            "telephone_number": "209-521-9661",
            "fax_number": "209-521-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "HASSAN",
        "middle_name": "MOHAMED",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G70661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902828841",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.