Individual provider Active NPI

Ahmad Qaddour, M.D.

  • Cardiovascular Disease Physician
  • Wichita, KS
National Provider Identifier
1003160987
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
04-36484 Issued in KS
Practice address
9300 E 29TH St N
Suite 310
Wichita, KS 67226-2182
Phone
(316) 858-9000
Fax
(316) 858-9005
NPI assigned
Oct 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 04-36484 KS Primary
Internal Medicine Physician 207R00000X 04-36484 KS

Addresses

Primary practice location

9300 E 29TH St N
Suite 310
Wichita, KS 67226-2182

Mailing address

9300 E 29TH St N
Suite 310
Wichita, KS 67226-2182
Phone (316) 858-9000

Other identifiers 1

IdentifierTypeStateIssuer
201103480AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141230000976 KS Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 5890949374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas Medical Center LLCGroup PAC ID 2668476862, 54 clinicians

Practice addresses (Care Compare)

9840 E 21St St N
Cypress Heart
Wichita, KS 67206-3589
Phone (316) 858-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.33 of 100Reported as group
Quality
59.78
Promoting interoperability
97
Improvement activities
40
Cost
73.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-36484KSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Medical Center, LLC Current Accepting new patients
Kansas Medical Center LLC Current Accepting new patients
Kansas Medical Center, LLC Current Accepting new patients
Kansas Medical Center, LLC Cardiovascular Disease CurrentSince Nov 15, 2014 Accepting new patients

Locations

1124 W 21st St
Andover, KS 67002
Phone (316) 300-4000

315 W 15th St
Liberal, KS 67901
Phone (620) 624-1651

2600 Ottawa Rd
Neodesha, KS 66757
Phone (620) 325-2611

9300 E 29th St N
Ste 310
Wichita, KS 67226
Phone (316) 612-1833

9840 E 21st St N
Wichita, KS 67206
Phone 31685890005811

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/meade-5283572b
  • FHIR API: https://api.platform.athenahealth.com/12044/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/6facadf3-e724-4db7-a26f-0449710dbd8a/
  • FHIR API: https://api.platform.athenahealth.com/6882/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1003160987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 E 29TH ST N",
            "address_2": "SUITE 310",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262182",
            "telephone_number": "316-858-9000",
            "fax_number": "316-858-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 E 29TH ST N",
            "address_2": "SUITE 310",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262182",
            "telephone_number": "316-858-9000",
            "fax_number": "316-858-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QADDOUR",
        "first_name": "AHMAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-31",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KS",
            "license": "04-36484",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-36484",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201103480A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.