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RAFID J HUSSEIN DO
NPI 1396763645
Internal Medicine - Gastroenterology in Gallatin, TN

Active since July 17, 2006PECOS EnrolledAccepts Medicare Assignment
92.57/100
CMS Quality Rating
300 STEAM PLANT RD STE 450, GALLATIN, TN 37066(615) 822-6716(615) 328-3709 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Rafid J Hussein Do NPPES

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

RAFID J HUSSEIN DO (NPI 1396763645) is an individual gastroenterology provider in Gallatin, Tennessee, licensed in Missouri (1009014097) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Sumner Regional Medical Center, and is a graduate of Des Moines University Of Osteopathic Medicine And Health Sciences (1997).

NPPES Registry Identity

NPI1396763645
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameRAFID J HUSSEINCredential: DO
Location Address300 STEAM PLANT RD STE 450Gallatin, TN 37066-3079
Mailing Address300 Steam Plant Rd Ste 450Gallatin, TN 37066-3079 · (615) 822-6716 · Fax (615) 328-3709
Phone(615) 822-6716
Fax(615) 328-3709
Sole ProprietorNo
Medical School CMSDes Moines University Of Osteopathic Medicine And Health SciencesGraduated 1997
Enumeration DateJuly 17, 2006
Last NPPES UpdateJanuary 22, 2025
NPPES CertifiedJanuary 22, 2025
✔ NPI 1396763645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in MO · 1009014097
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
300 STEAM PLANT RD STE 450, Gallatin, TN 37066
Open in Google Maps ↗

Other Identifiers 2

Medicaid036100635IL
Medicaid1396763645MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Rafid J Hussein Do 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 ID4789587809
PECOS Enrollment IDI20240429002755
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.

Areas of Expertise CMS Part B claims 9

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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
62 services61 patients
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.
56 services46 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
55 services55 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
45 services45 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
34 services33 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
29 services29 patients

Hospital Affiliations CMS Care Compare 2

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

Sumner Regional Medical Center

Acute Care Hospitals · Gallatin, TN
1/5 CMS rating
OwnershipProprietary
CMS Certification Number440003
Location555 Hartsville PikeGallatin, TN 37066 · Sumner County
Emergency services Birthing friendly

Tristar Hendersonville Medical Center

Acute Care Hospitals · Hendersonville, TN
4/5 CMS rating
OwnershipProprietary
CMS Certification Number440194
Location355 New Shackle Island RdHendersonville, TN 37075 · Sumner County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37066 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
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

92.57/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.03
Promoting Interoperability88
Improvement Activities40

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 Rafid Hussein's NPI number?

The NPI number for Rafid Hussein is 1396763645. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Where is Rafid Hussein located?

Rafid Hussein practices at 300 Steam Plant Rd Ste 450, Gallatin, TN 37066. The listed phone number is (615) 822-6716.

What is Rafid Hussein's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Rafid Hussein enrolled in Medicare?

Yes. Rafid Hussein 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.

What insurance does Rafid Hussein accept?

Health plans from BlueCross BlueShield of Tennessee list Rafid Hussein 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 Rafid Hussein affiliated with any hospitals?

According to CMS data, Rafid Hussein is affiliated with Sumner Regional Medical Center and Tristar Hendersonville Medical Center.

When was this NPI record last updated?

The NPPES record for Rafid Hussein was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.