Individual provider Active NPI

Omar Shaban

  • Emergency Medicine Physician
  • Iowa City, IA
National Provider Identifier
1053986968
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD-55039 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 353-6360
Fax
(319) 353-7006
NPI assigned
May 24, 2021
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD-55039 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 353-6360

Other practice location 1

400 E Polk St
Washington, IA 52353-1237
Phone (319) 353-6360

Other practice location 2

701 W Forevergreen Rd
North Liberty, IA 52317-9848
Phone (319) 353-6360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20250710003791 IA Practitioner - Emergency Medicine 3577943265 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Hospital Current Accepting new patients
Washington County Hospital CurrentSince Oct 9, 2025 Accepting new patients
Washington County Hospital CurrentSince Aug 1, 2025 Accepting new patients
Washington County Hospital Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
State University of Iowa CurrentSince Jul 1, 2025 Accepting new patients

Locations

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

701 W Forevergreen Rd
North Liberty, IA 52317
Phone (319) 356-2223

400 E Polk St
Washington, IA 52353
Phone (319) 653-5481

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/washin-6836dd27

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1053986968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-353-6360",
            "fax_number": "319-353-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-353-6360",
            "fax_number": "319-353-7006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E Polk St",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "IA",
            "postal_code": "523531237",
            "country_code": "US",
            "telephone_number": "319-353-6360",
            "fax_number": "319-353-7006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 W Forevergreen Rd",
            "address_purpose": "LOCATION",
            "city": "North Liberty",
            "state": "IA",
            "postal_code": "523179848",
            "country_code": "US",
            "telephone_number": "319-353-6360",
            "fax_number": "319-353-7006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHABAN",
        "first_name": "OMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "MD-55039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.