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DR. SOPHIA HUSSAIN M.D.
NPI 1386962199
Family Medicine in Mckinney, TX

Active since May 05, 2010PECOS EnrolledAccepts Medicare Assignment
6717 ELDORADO PKWY STE 120, MCKINNEY, TX 75070(972) 369-0744(972) 369-0644 Get Directions Write a Review

NPPES record last updated: October 17, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 17, 2019, Mar 23, 2017 (2 updates tracked since 2017).

About Dr. Sophia Hussain M.d. NPPES

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

DR. SOPHIA HUSSAIN M.D. (NPI 1386962199) is an individual family medicine provider in Mckinney, Texas, licensed in Texas (R1390) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS, is affiliated with Medical Center Of Mckinney, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1386962199
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SOPHIA HUSSAINCredential: M.D.
Location Address6717 ELDORADO PKWY STE 120Mckinney, TX 75070-5734
Mailing Address6717 Eldorado Pkwy Ste 120Mckinney, TX 75070-5734 · (972) 369-0744 · Fax (972) 369-0644
Phone(972) 369-0744
Fax(972) 369-0644
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateMay 5, 2010
Last NPPES UpdateOctober 17, 20192 updates tracked since enumeration
✔ NPI 1386962199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in TX · R1390✔ Licensed in NC · 165052
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
6717 ELDORADO PKWY STE 120, Mckinney, TX 75070
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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

Dr. Sophia Hussain 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 ID4082848767
PECOS Enrollment IDI20191001000822
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 Reassignments

3

Medicare enrollment records show Sophia Hussain reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Texas Health Physicians Group
20 mi
Internal Medicine
8440 WALNUT HILL LN STE 800
Dallas, TX 75231
  • Reassigned Medicare billing, Texas enrollment
  • 1,639 clinicians in this Medicare group
NPI 1053767897 (214) 860-6300
Eagle Physicians And Associates PA
973 mi
Family Medicine
1510 NC HIGHWAY 68 N
Oak Ridge, NC 27310
  • Reassigned Medicare billing, North Carolina enrollment
  • 179 clinicians in this Medicare group
NPI 1982773206 (336) 644-0111
Wakemed Specialists Group, LLC
1,035 mi
Obesity Medicine
160 MACGREGOR PINES DR
Cary, NC 27511
  • Reassigned Medicare billing, North Carolina enrollment
  • 997 clinicians in this Medicare group
NPI 1013571587 (919) 234-4468

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 11

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
359 services155 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
303 services158 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
48 services40 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
36 services36 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
35 services35 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
23 services23 patients

Hospital Affiliations CMS Care Compare 4

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

Medical Center Of Mckinney

Acute Care Hospitals · Mckinney, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450403
Location4500 Medical Center DriveMckinney, TX 75069 · Collin County
Emergency services Birthing friendly

Texas Health Presbyterian Hospital Plano

Acute Care Hospitals · Plano, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450771
Location6200 W Parker RdPlano, TX 75093 · Collin County
Emergency services Birthing friendly

Texas Health Presbyterian Hospital Allen

Acute Care Hospitals · Allen, TX
4/5 CMS rating
OwnershipGovernment - Federal
CMS Certification Number450840
Location1105 Central Expressway NorthAllen, TX 75013 · Collin County
Emergency services Birthing friendly

Baylor Scott And White Medical Center Mckinney

Acute Care Hospitals · Mc Kinney, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670082
Location5252 West University DriveMc Kinney, TX 75071 · Collin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75070 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Other Providers at the Same Location NPPES

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

SHINY MICHAEL FNP-BC
Nurse Practitioner (Family)
6717 ELDORADO PKWY STE 120
MCKINNEY, TX 75070
Collin County (972) 369-0744

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 Sophia Hussain's NPI number?

The NPI number for Sophia Hussain is 1386962199. It was assigned to this individual provider in the NPPES registry on May 5, 2010.

Where is Sophia Hussain located?

Sophia Hussain practices at 6717 Eldorado Pkwy Ste 120, Mckinney, TX 75070. The listed phone number is (972) 369-0744.

What is Sophia Hussain's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sophia Hussain enrolled in Medicare?

Yes. Sophia Hussain 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 organizations bill Medicare for Sophia Hussain's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sophia Hussain reassigns Medicare benefits to 3 organizations: Texas Health Physicians Group (Dallas, TX), Eagle Physicians And Associates PA (Oak Ridge, NC) and Wakemed Specialists Group, LLC (Cary, NC). Each 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 Sophia Hussain's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sophia Hussain accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Sophia Hussain 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 Sophia Hussain affiliated with any hospitals?

According to CMS data, Sophia Hussain is affiliated with Medical Center Of Mckinney, Texas Health Presbyterian Hospital Plano, Texas Health Presbyterian Hospital Allen and Baylor Scott And White Medical Center Mckinney.

When was this NPI record last updated?

The NPPES record for Sophia Hussain was last updated on October 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.