Individual provider Active NPI

Wesam Z. Sabbahi, MD

  • Internal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1104481571
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11888622-1205 Issued in UT
Practice address
30 N 1900 E RM 4C104
Salt Lake City, UT 84132-0002
Phone
(801) 581-7606
NPI assigned
May 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11888622-1205 UT Primary

Addresses

Primary practice location

30 N 1900 E RM 4C104
Salt Lake City, UT 84132-0002

Mailing address

30 N 1900 E RM 4C104
Salt Lake City, UT 84132-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20250718001252 DE Practitioner - Internal Medicine 2163840828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Physician Network, Inc.Group PAC ID 7315901253, 115 clinicians

Practice addresses (Care Compare)

Seaford, DE 19973
Phone 30262966118802

100 Rawlins Dr
Seaford, DE 19973-5881
Phone (302) 990-3300

Hospital & facility affiliations

  • Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006
  • Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Physician Network, Inc. CurrentSince Jul 1, 2025 Accepting new patients

Locations

100 Rawlins Dr
Seaford, DE 19973
Phone (302) 536-5415

801 Middleford Rd
Seaford, DE 19973
Phone (302) 628-9178

Organizations & group practices 1

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 2

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": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1104481571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 4C104",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 4C104",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABBAHI",
        "first_name": "WESAM",
        "middle_name": "Z.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-01",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "11888622-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.