Muhammad Moshfeq Hossain, D.O.
Individual provider Active NPI Family Medicine Physician · Hometown, IL
NPI 1982130159 · NPPES record last updated Feb 5, 2019
Key facts
- NPI
- 1982130159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 125.070004 (IL)
- Practice address
- 4140 Southwest Hwy
Hometown, IL 60456-1135 - Phone
- (708) 422-5700
- Fax
- (708) 422-8225
- NPI assigned
- May 10, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ascension Medical Group-Southeast Wisconsin Inc
Practice addresses (Care Compare)
10180 Washington Ave
Mount Pleasant, WI 53177-1604
Phone (262) 687-4011
Hospital & facility affiliations
- Ascension at Home
- Ascension All Saints Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200902000333 | WI | Practitioner - Family Practice | 8022387885 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.070004 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Medical Group-Southeast Wisconsin Inc | Single Specialty | Current |
Accepting new patients |
| Ascension All Saints Hospital, Inc | Single Specialty | Past | Accepting new patients |
Locations
13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400
10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040
201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 125.070004 | IL | Yes |
Addresses
Primary practice location
4140 Southwest Hwy
Hometown, IL 60456-1135
Mailing address
4140 Southwest Hwy
Hometown, IL 60456-1135
Phone (708) 422-5700
Other providers in Hometown, IL
- Angela Chambers-Jones
- Chicago Medivan LLC
- Moriah Elusta
- Hometown Dental Care PC
- Hometown Fire Protection District
- Misha Jane Ivetich
- Ashok Jhanji
- Themi Jouras
- Jolyne Noel Kaar
- Edward J Kim
All providers in Hometown, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.