Active NPI
Samer Nabil Muallem, M.D.
- Interventional Cardiology Physician
- Chicago, IL
National Provider Identifier
1023549920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 036.168688
- Practice address
- 251 E Huron St
Chicago, IL 60611-3055 - Phone
- (312) 926-2000
- NPI assigned
- Mar 22, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD469899 | PA | |
| Cardiovascular Disease Physician | 207RC0000X | MD469899 | PA | |
| Interventional Cardiology Physician | 207RI0011X | 036.168688 | IL | Primary |
Addresses
Primary practice location
251 E Huron St
Chicago, IL 60611-3055
Mailing address
465 N Park Dr Apt 905
Chicago, IL 60611-0005
Phone (610) 406-3956
Other practice location 1
500 University Dr
Hershey, PA 17033-2360
Phone (800) 243-1455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033170000001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Jefferson Medical College of Thomas Jefferson University, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2605 Keiser Blvd
Wyomissing, PA 19610-3338
Phone (670) 685-8500
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 1-10 |
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD469899 | PA | MD | Internal Medicine Physician |
| 036.168688 | IL | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penn State Health Medical Group, LLC | Current | Accepting new patients | |
| Penn State Health Medical Group, LLC | Current | Accepting new patients | |
| Penn State Health Medical Group, LLC | Cardiovascular Disease | Past | Accepting new patients |
Locations
500 University Dr
Hershey, PA 17033
Phone (717) 531-8181
500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131
1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141
2605 Keiser Blvd
Wyomissing, PA 19610
Phone (610) 685-8500
Organizations & group practices 3
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.
-
- Hematology & Oncology Physician
- Harrisburg, PA
- NPI 1861988644
-
- Diagnostic Radiology Physician
- Harrisburg, PA
- NPI 1457824013
-
- Cardiovascular Disease Physician
- Camp Hill, PA
- NPI 1134874779
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- West Reading, PA
- NPI 1467007112
-
- General Acute Care Hospital
- West Reading, PA
- NPI 1669530069
-
- General Acute Care Hospital
- Reading, PA
- NPI 1699734665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718236800000",
"number": "1023549920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 N PARK DR APT 905",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606110005",
"telephone_number": "610-406-3956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 E HURON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606113055",
"telephone_number": "312-926-2000"
}
],
"practiceLocations": [
{
"address_1": "500 University Dr",
"address_purpose": "LOCATION",
"city": "Hershey",
"state": "PA",
"postal_code": "170332360",
"country_code": "US",
"telephone_number": "800-243-1455",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MUALLEM",
"first_name": "SAMER",
"middle_name": "NABIL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-22",
"last_updated": "2024-06-13",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD469899",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "PA",
"license": "MD469899",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "IL",
"license": "036.168688",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1033170000001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.