Mustapha I Hydara, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60125636 Issued in WA

Practice address

615 W Titus St
Kent, WA 98032-5749

Phone

(253) 670-4234

Fax

(253) 631-1375

NPI assigned

Nov 23, 2009

Last updated

May 15, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

83.24 of 100Reported as group

Quality

76.66

Improvement activities

40

Cost

70.27

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• BHC Fairfax Hospital Inc.

  dba Fairfax Physician Group

  • Psychiatry Physician
  • Kirkland, WA
  • NPI 1104959097
  Medicare reassignment NPD
• BHC Fairfax Hospital Inc

  • Psychiatric Hospital
  • Kirkland, WA
  • NPI 1053327890
  NPD (past)

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1972831451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13216 SE 263RD PL",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980423548",
            "telephone_number": "253-347-2665",
            "fax_number": "253-631-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W TITUS ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980325749",
            "telephone_number": "253-670-4234",
            "fax_number": "253-631-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDARA",
        "first_name": "MUSTAPHA",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-23",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60125636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Thy Le Huynh
• Kristy Huynh
• Chung-Long Hwang, D.D.S., P.S.
• Thomas Hwang
• Abiesatou Hydara
• Jeremy Edward Hyde, L.M.P.
• Jennice Hyden, L.AC.
• Nancy Hylton, PT, LO
• Hibaq A Ibrahim, RN
• Icare Psychiatry PLLC

• Psychiatric/Mental Health Nurse Practitioner in Kent, WA
• Providers in Kent, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.