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HUSSIEN A BALLOUT M.D.
NPI 1376955682
Internal Medicine in Vero Beach, FL

Active since May 21, 2014PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1931 19TH PL, VERO BEACH, FL 32960(321) 387-9451 Get Directions Write a Review

NPPES record last updated: January 28, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 28, 2023, Feb 24, 2023, Jul 21, 2022 and 6 more (9 updates tracked since 2017).

About Hussien A Ballout M.d. NPPES

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

HUSSIEN A BALLOUT M.D. (NPI 1376955682) is an individual internal medicine provider in Vero Beach, Florida, licensed in Florida (ME131941) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, is affiliated with Holmes Regional Medical Center, and is a graduate of Saginaw Valley Medical College - Nlg (2014).

NPPES Registry Identity

NPI1376955682
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameHUSSIEN A BALLOUTCredential: M.D.
Location Address1931 19TH PLVero Beach, FL 32960-3555
Mailing Address1931 19th PlVero Beach, FL 32960-3555 · (321) 387-9451
Phone(321) 387-9451
Sole ProprietorNo
Medical School CMSSaginaw Valley Medical College - NlgGraduated 2014
Enumeration DateMay 21, 2014
Last NPPES UpdateJanuary 28, 20259 updates tracked since enumeration
NPPES CertifiedJanuary 28, 2025
✔ NPI 1376955682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME131941
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1931 19TH PL, Vero Beach, FL 32960
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Other Identifiers 4

OtherJA255YFL · Medicare Ptan
Medicaid021027500FL
OtherP02091198FL · Rrmedicare Ptan
OtherJA255ZFL · Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Hussien A Ballout M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42504318
PECOS Enrollment IDI20170802003319
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.

Medicare Billing Reassignment

Medicare enrollment records show Hussien Ballout reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ballout International PLLC
Same address
Internal Medicine
1931 19TH PL
Vero Beach, FL 32960
  • Reassigned Medicare billing, Florida enrollment
  • 53 clinicians in this Medicare group
NPI 1629554225 (321) 387-9451

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
1,795 services584 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
694 services619 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
462 services234 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
248 services232 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Holmes Regional Medical Center

Acute Care Hospitals · Melbourne, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100019
Location1350 S Hickory StMelbourne, FL 32901 · Brevard County
Emergency services Birthing friendly

Cleveland Clinic Indian River Hospital

Acute Care Hospitals · Vero Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100105
Location1000 36th StVero Beach, FL 32960 · Indian River County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32960 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$135.56 typical visit price
range $58.56 – $179.05
Typical copayment $33.89 (range $14.64 – $44.76)
Most-billed visit code 99204
Established Patient
$103.21 typical visit price
range $18.44 – $144.68
Typical copayment $25.80 (range $4.61 – $36.17)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
2 suppliers12 claims12 services$9.36 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196
DME-Medical/Surgical Supplies · category DA023N
2 suppliers22 claims954 services$6.99 avg. paid by Medicare
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6219
DME-Medical/Surgical Supplies · category DA023N
1 supplier13 claims293 services$0.92 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
4 suppliers39 claims39 services$37.14 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261
DME-Hospital Beds · category DB000N
2 suppliers14 claims14 services$46.75 avg. paid by Medicare
Manual wheelchair accessory, wheel braking system and lock, complete, each E2228
DME-Wheelchairs · category DD021N
1 supplier18 claims35 services$54.62 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

ANDREA LOVING DO
Neuromusculoskeletal Medicine & OMM
1931 19TH PL
VERO BEACH, FL 32960
Indian River County (321) 387-9451
BALLOUT INTERNATIONAL PLLC
Internal Medicine
1931 19TH PL
VERO BEACH, FL 32960
Indian River County (321) 387-9451
LINDSAY TUCKER DNP, FNP-C
Nurse Practitioner (Family)
1931 19TH PL
VERO BEACH, FL 32960
Indian River County (541) 321-3732
ASHLEY LANIER APRN
Nurse Practitioner (Family)
1931 19TH PL
VERO BEACH, FL 32960
Indian River County (321) 387-9451

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 Hussien Ballout's NPI number?

The NPI number for Hussien Ballout is 1376955682. It was assigned to this individual provider in the NPPES registry on May 21, 2014.

Where is Hussien Ballout located?

Hussien Ballout practices at 1931 19th Pl, Vero Beach, FL 32960. The listed phone number is (321) 387-9451.

What is Hussien Ballout's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Hussien Ballout enrolled in Medicare?

Yes. Hussien Ballout is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Hussien Ballout's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hussien Ballout reassigns Medicare benefits to Ballout International PLLC (Vero Beach, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hussien Ballout's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Hussien Ballout accept?

Health plans from Cigna HealthCare of Florida, Inc. and Cigna Healthcare list Hussien Ballout as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Hussien Ballout affiliated with any hospitals?

According to CMS data, Hussien Ballout is affiliated with Holmes Regional Medical Center and Cleveland Clinic Indian River Hospital.

When was this NPI record last updated?

The NPPES record for Hussien Ballout was last updated on January 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.