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MOHAMED HUSSAM HALLAK
NPI 1255132585
Student in an Organized Health Care Education/Training Program in Orange Park, FL

Active since March 22, 2025PECOS Enrolled
2001 KINGSLEY AVE, ORANGE PARK, FL 32073(904) 639-8500 Get Directions Write a Review

NPPES record last updated: March 27, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 27, 2025, Mar 22, 2025 (2 updates tracked since 2025).

About Mohamed Hussam Hallak NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOHAMED HUSSAM HALLAK (NPI 1255132585) is an individual student in an organized health care education/training program in Orange Park, Florida and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255132585
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMOHAMED HUSSAM HALLAK
Location Address2001 KINGSLEY AVEOrange Park, FL 32073-5148
Mailing Address2001 Kingsley AveOrange Park, FL 32073-5148
Phone(904) 639-8500
Sole ProprietorNo
Enumeration DateMarch 22, 2025
Last NPPES UpdateMarch 27, 20252 updates tracked since enumeration
NPPES CertifiedMarch 27, 2025
✔ NPI 1255132585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2001 KINGSLEY AVE, Orange Park, FL 32073
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mohamed Hussam Hallak is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. FORREST KING M.D.
Emergency Medicine
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-8500
DIANA LYNN BRIDGES ARNP
Nurse Practitioner (Family)
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-8500
TOMAS LUKE LAMBERT MD
Student in an Organized Health Care Education/Training Program
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-2000
CHRISTY GIEGER PA-C
Physician Assistant (Surgical)
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 314-7733
DR. BENJAMIN ROBERT COOPER DO
Student in an Organized Health Care Education/Training Program
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-8500
CHIRAAG ASHOKKUMAR MD
Student in an Organized Health Care Education/Training Program
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-2005
DR. ALEXANDER NATHANIEL HOWELL DO
Dermatology
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-2000
KUNAL PATEL DO
Student in an Organized Health Care Education/Training Program
2001 KINGSLEY AVE
ORANGE PARK, FL 32073
Clay County (904) 639-2005

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mohamed Hussam Hallak's NPI number?

The NPI number for Mohamed Hussam Hallak is 1255132585. It was assigned to this individual provider in the NPPES registry on March 22, 2025.

Where is Mohamed Hussam Hallak located?

Mohamed Hussam Hallak practices at 2001 Kingsley Ave, Orange Park, FL 32073. The listed phone number is (904) 639-8500.

What is Mohamed Hussam Hallak's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mohamed Hussam Hallak enrolled in Medicare?

Yes. Mohamed Hussam Hallak is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mohamed Hussam Hallak was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.